Pharmacopoeia and materia medica : composed for the use of young physicians, and especially intended to accompany the pathological system of medicine

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PHARMACOPCEIA

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MATERIA MEDIC A.

PHARMACOPOEIA

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AND

MATERIA MEDICA:

COMPOSED FOR THE

USE OF YOUNG PHYSICIANS,

AND

ESPECIALLY INTENDED TO ACCOMPANY

THE

PATHOLOGICAL SYSTEM OF MEDICINE.

BY

JOHN BELL,

SURGEON.

EDINBURGH:

Printed by J. Pillans Sons ;

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TO

Dr JAMES HOME,

PROFESSOR OF MEDICINE AND MATERIA MEDICA

IN THK

UNIVERSITY OF EDINBURGH,
THIS VOLUME IS PRESENTED BY THE

AUTHOR.

AS AN INDEPENDENT TESTIMONY OF RESPECT

FOR

HIS HIGH ATTAINMENTS IN GENERAL LEARNING,
AND IN PROFESSIONAL KNOWLEDGE,

AND FOR

HIS MODEST, DILIGENT, AND ABLE CONDUCT IN
* HIS HIGH OFFICE OF A TEACHER OF

MEDICAL SCIENCE.

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NOTICE.

This Volume will, I trust, be found useful to the
Student, and not unacceptable to those already
engaged in Practice. It is the Third, or Supple-
mentary Volume, of a System of Practice founded
on Pathology, now in the Press ; — and it is printed
first, that the cyphers, marking the number of each
Prescription, may correspond correctly with the
System of Practice.

.T. B.

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PRELIMINARY VIEW

OF

MEDICINES AND MEDICAL PRESCRIPTIONS.

It is difficult to represent to the young physician, the
simplicity and unity of design which should pervade all
his prescriptions. But this unity of design appears only
in the practice of those who have learnt by expe-
rience, method, and real science, to have a distinct in-
tention in each professional act; who understand the
organ diseased, detect its condition, and know when to
hope for salutary changes in its structure, and how to
promote them, and how to regulate the sensibilities, the
secretions, and the actions of the system. Much more
difficult must it be, to lay before the young physician .
an ample catalogue of approved and efficient medicines,
and to reconcile the various forms in which they are
prescribed, with such unity of design.

Indeed, it seems to me so arduous a task to prepare
the mind of the young physician, and enable him at
once to form his plan of cure, and to prescribe with
seeming variety, and real unity of design, that I have
thought it best, to separate the two departments, viz,

VOL. III. A

INTRODUCTION.

thinking, and prescribing! to establish the one as a
philosophical and rational, the other as a mechanical art ;
to resolve the art of curing into as many distinct pro-
cesses as there are forms of disease ; and to fill up these
simple intentions with a due variety of prescriptions.

With many, practice is made to consist, rather in
curious and delicate prescriptions, than in sound and
judicious intentions, arising out of a just conception of
the structure of the affected part, of its disordered feel-
ings, or of the incited vascular actions which are to be
assuaged and subdued ; who repeat, to the hourly vexa-
tion of the sick, tlie same unmeaning di’aught, and
bolus, and pill, without even the charitable intention of
sustaining the patient’s hope and faith, in the art which
teazes him. IVIany seem actuated by no worthier pur-
pose, than that of repeating tri\aal prescriptions from
liour to hour, which a few spoonfuls of a medicated
julep at given periods, could so much more honestly
replace.

I would divert the young physician ^from this, the
specious art of prescribing, to the faithful and honour-
able intention of curing, and that in the easiest and
plainest way : I would have him admit no compromise
in his dignified office, nor think of any other party than
his patient and himself. The patient is seldom wanting in
that grateful confidence and implicit faith, which should,
on the part of the physician, be faithfully and loyally
repaid.

And I would seek to establish this art of prescribing,
in which all our acquired knowledge terminates, on a
philosophical conviction of the power we have over the
nervous sensations, and vascular actions of the body,
and its several organs : a power which many seem to
doubt, and some flatly deny, and which all those may
be said not to acknowledge, who give themselves up to

INTRODUCTION.

3

the modern and refined science, of prescribing in varied
forms the same unmeaning things.

The influence of medicines on the human body, is
established by Nature’s law ; for the animal body is a
sentient and acting machine, whose nerves are destined to
feel every impression ; its vessels meanwhile, and the or-
gans of course, which the congregated and contorted ves-
sels form, responding to each new sensation, or exciting
power. The whole frame is “ subject to every skyey
influence,” and the impressions and effects of medical
powers, depend on the same sensations, and responding
actions, by wliich air, light, heat, passion, emotion, sen-
sation of any kind, preserve the bodily frame in action
and in life.

Those sensations, and responding actions, reside in
the two orders of parts which constitute the bulk of the
animal body, viz. the nerves and the vessels, whose sym-
pathies are mutual and reciprocal. Whatever the nerves
feel, begets action in the arteries ! whatever action the
arteries assume, affects the sensorial power of the brain
and nei-ves ! Familiar stimuli, and medical exciting
powers, have stiU but one effect: Whether it is our
purpose, to regulate the flmctions of the animal body,
by subduing, or by exciting vascular action, by deaden-
ing, or rousing the sensibihty of the nerves, the whole
system is affected as distinctly by ordinary exciting
powers, as by those strictly medical ! It is affected by
the most simple and transient impressions, by light,
heat, noise, or wine, for example, as distinctly as by the
most mortal influence of poison or infection.

The human body does not, hke that of simple animals,
or insects rather, resemble merely a barometer dr ther-
mometer, expanded by heat, condensed by pressure, or
affected by moisture : it is a complicated machine, of
which each organ is an essential part ; and while eacli,

A 2

4

INTRODUCTION.

/

organ is constituted of arteries, veins, and nerves, the
health, feelings, functions, and secretions of such organ,
whether it be the skin, the eye, the stomach, the liver,
the kidney, is affected by the state of action of its own
vessels : Thence comes disease.

Mere sensation, however violent, unusual, and even
painful, heat, ( e. g.) light, motion, the tumultuous and
transient excitements caused by grief, joy, intoxication,
opium, or slighter poisons, do not constitute disease.
Disease begins when the circulation in parts and organs
becomes irregular, when the structure of the part is
endangered, or when sensation in the nervous power is
affected in its very source in the brain. These excited
conditions, then, are not disease, but the causes of dis-
ease, i. e. of disordered organization. Almost aU disease
is marked by Fever, and fever consists in quickened
circulation, obstructed secretions, and confused senso-
riiim : sensation, and pain, and additional distress, arise
in proportion to the importance and the offices of the
parts which principally suffer.

Over those very properties which are thus disordered,
over the sensation, vascular action, and various secretions
of the animal body, our medicines have a manifest
power, even to the extremes of exciting destructive
action, or of deadening sensation to the point of entirely
extinguishing life : and in the discreet use of those more
efficacious stimulant and narcotic powers, which we
call medicines, does the perfection of our art consist.
By exciting general secretions, we relieve the whole sys-
tem : by increasing particular secretions, as urine or perspi-
ration, we compensate for others that are suppressed ; by
facilitating such evacuations as menstruation, we prevent
universal disorder ; by raising the action of vessels on
an external surface, we reheve the throat, the lungs, the
liver, the knee-joint, or other internal part.

INTRODUCTION.

Nor is it only by exciting more acute sensation, or
stimulating to increased action, that we procure salutary
changes ; it is equally in our power to prevent destruc-
tive excitements, ruining the organization of parts es-
sential tq life : We have, at the least, an equal propor-
tion of sedative and narcotic powers; — of Narcotic
Powers, such as are capable of poisoning for a time the
whole sentient system, so as to render it no longer sus-
ceptible of pain, nor indeed of any feeling but that
which we choose to impress ! — of Sedative Powers,
capable of lowering the action of all the vascular system,
or of the vessels of any individual organ, till life almost
ceases in the part.

These are the elements of that philosophy, and of
those physical applications, by which we are able to
alter the feelings, and the state of vascular action in the
living body, or in its particular organs ; and he who
doubts whether we have the power of curing disease,
must subscribe to this solecism in nature, — “ That though
it is manifest, that the animal body is sustained in life
and action, by the unceasing operation of various exter-
nal powers, upon those properties with which the animal
body is endowed by nature ; though its various diseases
are mere aggravations of its natural sensations, or undue
excitement of its healtliful vascular actions, proceeding
from excess, or irregularity in the use of those ordinary
exciting powers ; though we are acquainted with all the
natural, and with many medical agents by which these
actions and feelings may be invigorated or restrained ;
yet have we no power over the sensation or action of
the animal frame, nor any means of arresting or remov-
ing disease !”

OF

6

CLASSIFICATION OF MEDICINES-

OF MEDICINAL POWERS.

These general views must serve as the rule of our ar-
rangement, since we define the several orders of medi-
cine, and class them, according to the influence they
have over those various properties of tlie living body,
or the actions of individual organs.

Sedatives.

By SEDATIVES, we aUay excessive vascular action,
and abate inflammatory disease. Sedative powers, are
chiefly the , abstraction of the usual exciting powers.
They are Cold, Bleeding, Darkness, Silence, Diluent
drinks. Nitre, Camphor, Super-tartrate of Potash, Vine-
gar, and other vegetable acids, and acid fruits ; and in
an especial manner, we value the sedative effect of Nau-
seating doses of Emetics, whose momentary power, in
lowering all the actions of the system, sui7>asses that of
all the others.

Narcotics.

By NARCOTICS, or anodynes, we act more direct-
ly on the sentient power ; we poison in a degree the
nervous system, lessen the sensibilities of the body,
slacken the pidse, allay excessive action, and save the
lungs or other viscera from the niinous effects of over-
powering vascular orgasm. The chief of this class are
OPIUM, HYOSCIAMUS, DIGITALIS, BELLADONA, CICUTA,
and other narcotic drugs ; drugs which bear such enmity
to life, as to poison the nervous energj’^ in its very source.

CLASSIFICATION OF MEDICINES.

7

to affect the whole nervous system through the stomach,
or even when outwardly applied ; and which, though so
powerful, as to need to be administered only in the small-
est doses, are yet the medicines in most familiar use.

Emetics and Purges,

By evacuating the primae vise by emetics and
purges, besides the benefit of unloading the system,
we have another less direct, but very poweifiil means
of lowering the tone of action throughout the whole
system, and of maintaining, by continued evacuations,
the dominion we have once obtained over the prime
functions of circulation in general, and of secretion in
the particular organs. Emetics and purges, in this
simple sense, are to be regarded merely as means of un-
loading the bowels, of undoing any mechanical obstruc-
tion, and of keeping the system low, by augmenting that
effusion from their exhalent surfaces, which is the se-
cretion the most readily and quickly excited.

Diaphoretics, Diuretics, Expectorants, and
Emmenagogues.

By diaphoretics, diuretics, expectorants,
and emmenagogues, we provoke the secretions of
sweat, of urine, of the mucus of the trachea, and of
menstruation : And such medicines are useful, not
merely as means of emptying and relieving the vas-
cular system, or of evacuating matters, whether in-
noxious or morbid, which interrupt the natural func-
tions, but of balancing the actions of the system, as
well as its secretions : of remedying, for example, ex-
cessive flow of urine, by increasing the perspiration ;
of opposing vomiting, or inverted vermicular motion,
to diarrhoea; of affecting thp uterine system, by irri-

s

CLASSIFICATION OF MEDICINES,

tating the lower intestines ; of exciting and enforcing
at one time the secretion of the skin, at another time
that of the bowels, at another time that of the uterine
system of vessels. And it is worth observing, that very
complex actions arise from every efficient remedy which
the physician prescribes : That not the slightest prescrip-
tion is indifferent, or without its consequences : That
there is no one animal function but has its dependent and
sympathising functions, nor any medicine which has not
various operations : That the excited or quiescent state
of the circulating system of the liver, the kidney, the
skin, the bowels, affects the secretion of these : And that
the condition of each secretory organ influences some
other, and changes in a degree the temperament and
sensations of the whole body.

Rubefacients.

By rubefacients, or applications which excite vas-
cular action on the surfaces of the body, we have it
in our power to substitute one action for another ; to so-
licit the blood from the internal and important organs
towards the superficial and less important parts ; and to
change for a trivial external inflammation a dangerous
internal disease. Inflammation of the trachea is thus
relieved by synapisms to the throat ; the torturing pain
of rheumatism is relieved, or the danger of white swell-
ing averted, by the application of tartrite of antimony,
turpentine, or camphorated oil, to the surface of the
joint ; the condition of the bowels, the lungs, or the
brain itself, is affected by the application of blisters.

Alteratives.

]\Iany important changes may be wrought on the
system, by the long-continued, slow, and powerful ope-

CLASSIFICATION OF MEDICINES. 9

i^ation of certain remedies, as Mercur}% Conium Macu-
latum, mineral waters, peculiar food, or the liberal im-
bibing of fluids. It is by maintaining a more moderate,
perhaps a peculiar action throughout the whole system,
by subduing sensibility for a length of time, or by main-
taining a lowered and moderate tone of action in the
vessels of a secreting organ, that we work these salu-
tary changes in its structure : But it is by empiricism, or,
in other terms, by experience only, that we learn how
to accomplish changes, which neither chemical science
nor pathological inquiries can enable us to comprehend.
We find that we have it in our power, by the slow, im-
perceptible operation of Alteratives, to extinguish some
diseases, and modify or ameliorate others. As the
medicines, viz. Mercury, Cicuta, Barytes, Arsenic, &c.
are administered gradually, and must be allowed to ope-
rate slowly, thence they are named alteratives ; and
as an avowal of our ignorance of their mode of operation,
or, to signify that they are tlie appropriate remedies of
certain diseases, they are often named specifics.

Stimulants.

We have hitherto enumerated chiefly the powers
which subdue or antagonize vascular action ; but there
are many and powerful ones, which operating through
the stomach and its great system of nerves, invigorate
and stimulate the whole body. The prime of these
which directly excite, and seem, in moderate doses, to
have no operation but that of excitement, are alkohol,
(ETHER, ammonia, and OPIUM, — for Opium may be so
^ven, in small and frequent doses, and so combin-
(?d with other dnigs, that its narcotic power, by which
chiefly it is known, never appears, while we experience
only its stimui.ant power.

10

CLASSIFICATION OF MEDICINES.

Tonics.

When medicines affect more the stomach than the
whole system, and, by a gentle and continued excite-
ment of the stomach, contribute to maintain all the other
functions in vigour, they are named tonics : And the
medicines which best deserve this title, are the tribe of
bitter barks, and roots ; ginger and other spices ; the va-
rious preparations of the Tormentilla Erecta, Chalybeate
W aters, and the oxides of Iron, Copper, and Zinc. With
some such medicines for exciting the function of the
stomach, and improving the strength, we usually con-
clude the cure, after any of those wasting diseases which
impair the habit.

‘ ' . Astringents.

Of the medicines operating solely on the internal surfa-
ces, not on the nerves, of the stomach and intestines, the
chief are those denominated astringents. Astringents
stimulate so little, that we are not conscious, after taking
them, of any degree of that excitement which stimulants
produce; and we use them safely to almost every extent.
Their influence seems to be chiefly in the vascular coats of
the stomach and bowels ; their effects ai-e the most conspi-
cuous and most immediate of any. Sulphuric Acid, or
the Nitric Acid, when used in hgemorrhagic fluxes from
the external surfaces of the stomach and bowels, (which
are indeed "very frequent diseases), may perhaps be re-
garded rather as styptic ; but the various astringent ve-
getables, the red rose, the oak-bark, the catechu
and Kino, so invaluable in protracted diarrhcea, in chro-
nic dysentery, and in habitual relaxation of the bowels.

CLASSIFICATION OF MEDICINES.

11

are true astringents, a property distinguished in various
individuals of the vegetable tribe, by their containing
Tannin, and the Gallic Acid, so as to strike a black colour
with solutions of iron, and to cause a precipitation from
gelatinous fluids.

Antacids, Anthelmintics, &c.

*

When we seek, by chemical agents, to correct
the chemical processes going on in the stomach or
bowels ; when we give Absorbents, as they are named,
viz. Magnesia and Lime, to neutralize acid ; or when
we give Anthelmintics, viz. mercurial preparations, tin,
semina santonica, or other medicines, to kill and expel
worms, suspected to he nesthng in the bowels, our pre-
scriptions are either chemical, or empyrical merely,
having no other relation to the hving powers or sensa-
tions of the animal body, than not to oflend or injure
the parts.

These are the classes of medicinal powers, which I
shall endeavour to teach the young physician how to
use with discretion and good sense. But it is not to be
disguised, that no medicine has those simple effects, and
those only from which it takes its order and precedence,
in a general enumeration or index of drugs. Each
medicine is complicated in its effects, yet not so as to
defeat the best pui-poses of arrangement. It is indeed
my settled opinion, that whatever confusion has been
perceived in the methodical arrangements of drugs, has
arisen from not referring invariably the chief influence
of each to corresponding properties of the hving, and
I should add, healthy system. Narcotic powers, for
example, which poison the nervous system, lower the
sensibility, depress and almost arrest the pulse, disorder

V2

OF SEDATIVES.

the brain, incapacitate the muscles, and stop, or at least
affect in a singular degree, all the secretions, are yet not
purely narcotic. They cannot be so. They must have
various influences, according to the condition of the
body. A NARCOTIC, when it lowers the frequency of
the pulse, may be called a sedative ; when it mode-
rates or quiets convulsive affections of the muscles, it I
may be called an antispasmodic ; when it restrains
profuse secretions, it may be called an astringent ; I
yet all this it does merely by its primary action in the i
healthy system, viz. allaying sensibility, and is Narcotic
still.

These are individual effects, then, resulting from one
general influence ; and it is the purpose of extempora-
neous prescription, so to temper each medicine, as to
modify its general power, and to produce, by combining
stimulants with tonics ! narcotics with astringents ! eme-
tics with narcotics, and anodynes with purges ! various
effects, which yet should not change the character, nor
alter the class of that medicine, on which the chief in-
fluence depends.

CLASSES AND CHARACTERS OF
MEDICINES.

First, Of Sedatives.

The class of sedatives may be defined — “ That selec-
tion of medicines, and of external applications, which have
the most remarkable influence in abating the vascular
actions, either of the animal frame in general, or of par-
ticular organs and parts.” — This class is of prime im-
portance in saving the brain, the lungs, and other vis-

OP BLEEDING.

13

cera, from the destructive effects of excited action. The
violence of arterial action throughout the whole system,
the alarming form of the individual disease, the atrocity
of the symptoms, all signify nothing, if only the struc-
ture of the organ chiefly affected, and its internal vas-
cular apparatus, can be preserved entire and unhurt:
However horrid the delirium, however intense the pain
or difficult breathing, if only the brain, the lungs, or
oth» diseased organ, be kept safe from the effects of
such impetuous circulation, the patient’s life is safe.
Hence we look to sedative medicines, and powers re-
pressing arterial action, though they be familiar and in
common use, with more interest than to all the other
tribes of medicine.

First, Bleeding, is the first, and most important of
sedative powers. The peculiar uses of bleeding, the de-
grees in which we may venture to drain the system of
its most vital fluid, or the rapidity with which the
blood may be allowed to flow, are marked in each indi-
vidual PROCESS of CURE: But at present, it is more

natural to intimate, in general rules, our opinion of its
importance. Bleeding is immediately required in all
sudden diseases, especially of young men, previously
in health and vigour, high in action, and friU of blood ;
in all diseases of the head, with few exceptions; in
aU haamorrhages, especially hsemoptysis, or haemorrhage
from the lungs ; and in all sudden diseases of the abdo-
men and abdominal viscera : In aU injuries from falls,
blows, and bruises, especially those in which the vis-
cera are so injured by the shock, that extravasation is
to be apprehended ; in aU active haemonfrages, uterine
haemorrhages not excepted ; in all disorders where
we have reason to believe that rapid circulation is
endangering any vital structure, whether announced.

3^

OF BLEEDING. — OF COLD.

as in disorders of the brain, by a rapid throbbing pulse,
or accompanied, as in disorders of the abdomen, by an
oppressed and feeble one.

As for the physical marks of that peculiar condition
of the system which most requires bleeding, they may
be thus described. When, after the sudden invasion of
anyi acute disease, the shivering has ceased, and the
throbbmg of the pulse begun ; when the skin is redden-
ed, the eyes suffused and swollen, the face bloated, the
tongue and mouth parched, the head confused, and the
limbs aching and trembling; bleeding is required straight-
way, and is of little use, unless tlie blood be drawn
off so suddenly and so profusely, as to abate at once the
.rapid pulse and confused feelings, to restore free breath-
ing, and clear the head ; and the only rule for its re-
petition is this, that the blood must be permitted to
flow while the oppressed pulse rises ! that it must be
repeated while the pulse thi'obs, and the head is affect-
ed! (for the brain first feels the force of hurried cir-
culation) ; that it must be repeated at intervals till the
pulse softens, becomes calm, and subsides into its na-
tural state, and below its usual standard ! General
bleeding alone is useful : topical bleeding, as from
the temples, over inflamed joints, in ophthalmia, in-
flammations of the throat, testicle, &c. &c. has little
influence, and what little influence topical bleeding has,
most probably arises from the influence of such local
bleeding, especially of cupping, in changing the course
of the circulation, just as the circulation of a part is
affected by the stimulating powers of rubefacients or
blisters.

Second^ Next in power, the highest indeed in general
influence, is cold, or we should rather, in regard to fe-
brile diseases, say coolness : for though cold, — intense
cold, — is very useful in abating the local and intense

on? COLD. — OF FEAR.

15

action of arteries in delirium, mania, and other acute
diseases of the brain ; though clay-caps, saline solutions,
vinegar, alcohol, aether, &c. are with great propriety
applied to the head in inflammations of the brain, to
the bowels in hernia, to the scrotum in violent inflam-
mation of the testicles, and to the skin in certain acute
diseases ; yet in fever, in exanthematous diseases, and in
Synocha, or common inflammatory fever, accompanied
with local affections, we allow only a cool atmosphere,
a stream of cool air passing across the chamber, and
ablutions with salt and vinegar, or vinegar and water
moderately cold, and modestly used.

But in local diseases, where there is danger of the
organ, the intestine, the testicle, &c. being essentially
injured ; we not only use the coolest applications, but
betake ourselves to various means of producing artificial
cold, especially by the evaporation of spirituous fluids,
as £ether, camphorated spirits, and various forms of em-
brocation : or we more directly abstract heat by the ap-
plication of ice or snow.

Third, Fear is to be enumerated among the subduing
powers which the physician sometimes avails himself of,
especially in cases of Mania, when its influence, physical
as well as moral, combined with long exposure to cold,
depresses very effectually the most tumultuous emotions
of mind, and the highest physical excitement of the
arterial system.

Fourth, Amongthe powers depressingthe system, none
is more effectual, not the most powerful even of those al !
ready enumerated, than nausea, excited and continued
by smaller doses of emetics. In the most tumultuous pa-
roxysms of mania, these are found the most subduing of
aU : The swinging machine has the same general ef-
fect directly on the sensorium, that emetics have by
tlieir influence on the sensible and nervous surface of the

IG

or EMETICS. — OF PURGES.

stomach ; and the sickening effect of irregular and yet
unremitting motion in a sea-voyage, depresses the pulse
of consumptive patients, as sensibly, as the sedative power
of Hyoscyamus.

In MANIA, DELIRIUM, and fever; ill hurried ac-
tions of the INTESTINAL CANAL; in hectic proceed-
ing from suppuration ; in inflammations of the liver
and lungs ; in Immorrliagic diseases from the sur-
face of the lungs, the uterus, the intestinal canal, or the
stomach itseff, nauseating doses of emetics prove the
most powerful sedatives. To operate as a sedative in
such diseases. Emetics should sm’ely be given not in such
full doses, as, by exciting vomiting, to drive the blood for
a time more rapidly through the brain, lungs, or other
diseased organs ! but, in doses so tempered and combined
with opiates and other medicines, as to produce, merely
nausea. The signs of their successful operation are sick-
ness, yawning, and depression of strength ; the pulse be-
comes slow and soft, the face pale, and the skin moist ;
saliva flows from the mouth, which was before parched
and dry ; the aching of the head ceases, and the flushing
of the face subsides ; the patient falls asleep, perspires
freely, and awakens composedly with clearer senses and
a softer pulse. Such ai'e the effects of smaller doses of
Antimony, of Pulvis Ipecacuanhas cum opio, and other
compound emetics presently to be mentioned.

Fifthy Purges are very powerful in subduing the ac-
tions of the system by their various influences on tlie in-
ternal surface of the alimentary canal, which is exquisitely
sensible, of great extent, and connected by sympathy,
or, in other terms, by the sensibility of its nerves, with
the whole sentient system. 1^^, Purges have the posi-
tive power of exciting a profuse secretion from all the
glandular apparatus and exhalent surfaces of the intes-
tines, which, as a means of draining the system of fluids.

OP ANTIPHLOGISTIC PURGES.

17

is very instant in its effect : They have a propor-

tioned indirect power of preventing the access of absorb-
ed fluids, or the replenishing of the system : 3cf,

Purges given even in the most moderate doses, but more
especially drastic purges, have a sickening, depressing,
poisonous effect ; the pain of the bowels is accompanied
with depression of the pulse, paleness of countenance, and
coldness of the extremities ; and very languid feelings, in-
variably accompany their operation ; in short, we find,
during their operation in aU febrile or inflammatory dis-
eases, the pulse more temperate, the skin cooler, and the
head clear. Mli, These are effects common to all purging
medicines ; but saline pufges have that peculiar opera-
tion which we so truly ascribe to aU saline medicines ;
they are, in addition to their purgative virtue, direct se-
datives : Operating merely as salts, they would sicken,
and depress the pulse,' though they did not purge ; just
as nitre, which has no effect as a cathartic, is the most
powerful sedative.

We therefore select saline purges for inflammatory
diseases, or diseases of accelerated arterial action, and
distinguish them by the titles of antiphlogistic, se-
dative, or COOLING purges: they are the least un-
pleasant and the least irritating ; and they are given,
not in the form of tinctures, piUs, &c. but dissolved
in large quantities of cold water. The chief of the
class are. Supertartrate of potass. Phosphate of soda.
Sulphas sodie, Soda Tartarisata, Tartras potassse. Other
purges are administered, more for their mechanical influ-
ence in emptying the intestinal tube, these for their in-
fluence on the general system : Other purges are used for
stimulating and sustaining the action of toipid bowels ;
for relieving congestions of feces ; for forcing obstruction,
as in Ileus and Hernia i for poisoning and expelling

VOL. TIT. B

18 NITRE.— CREAM OF TARTAR.— ALUMN.

worms, and for various other local influences, which ^all
be explained in the Section appropriated to Cathartics.

Sixth, Sedatives, or medicines so distinguished be-
cause of their direct influence in repressing vascular ac-
tion throughout the whole system.

The fust and most effectual of these is Nitre,
NiTRAS POTASS^, whose Sedative powers are parti-
cularly manifested, when, by inischance, it is taken
instead of some unoffending purge,, to the amount
of an ounce or more ; the person diesi in a ^few
hours, not from the intense vomiting and purging, as
after other poisons, so much as from the, universal
coldness, sinking of the pulse, fainting, and griping
pain in the stomach. This medicine we could as little
want as any, except opium it is, best given in the form
of cooling powder, draught, solution, or emulsion, to
the amount of 8 or 10 grains for a dose, repeated every
three hours. In Phrenitis cor brain fever, in Synocha car in-
flammatory fever, in sore throat, rheumatism, and haemor-
rhages, it is of most sensible usp in lowering the pulse.

Cream of tartar, superxartras potass^, is an in-
valuable medicine, from^ its pl^sant acidity, and yarious
virtues, sedative, diuretic, apd cathartic. As, ,a Seda--
live, it is useful throughout) tkp lyhole course of , fevers,
and of inflammatory and hjemQi’rhagic disea$es;4t is given
unsparingly, sometimes in the formal way of^,powders,
from hour to hour, to the amount of half aii ounce in the
day ; but it is best given in thp fpnn of acidulated drink,
with additions of sugar, lemon, juice, &:c.

AlUMN, supersulphas ARGipLuE ET POTASS.®, is IcsS
used in simple fever, though really and most conspicuous-
ly useful ; but clriefly in Inemorrhagic actions of the ves-
sels, as in Hcematemcsis, Mcpnorrluxgia, and Abortion.
It is given in separate doses ,from 5 to 15 grains, with the
addition of some aromatic to prevent entire sickness ; It is

BORAX, SPIRIT OF MINDERERiJS.

19

bttt given in the form of Alum-whey, Serum alumino-
siim : Two di-achms of powdered alUm being thrown in a
pint-basin of hot milk, makes the whey, which is drunk
cool by glassfulls, that is, in draughts of from 3 to 4
ounces.

Borax, sub-boras sod..e, resembles nitre in its slight
Irittemeiss, and in that cool taste, or feeling rather,
which its solution Ofi the mouth and tongue leaves
behind it, and especially in its sedative powers. Like
nitre, it has hardly any 'erf" the cathartic property common
to the other neutral salts'*>'it is too little used in inflatn-
matoiy disea^ ; it should be given in frequent draughts,
conveying each a scrupleOrmoreof the ^altj and repeated
every two OT' three holli’S.* ’ These three Salts, Nitre, Alum*
and Borai', ai#’ ^dsO hioTe used' as cOcSing solutions for
gargling thO' throaty 'and^waShshg tlia triotith and fauces,
than ahy'Otht^; 'and'^peidially>^^^Iafttei^; hs i sflirong sO-
lutionrbt^ih"fiOS^^^'1Mx^ with^i'sUgdH is used fit the
apthous Sores of (hildreh or adults. lovsi* > ,j£ mirf c ■

Acetas AMBfOi^i^' EiQUfnusy'‘«theJUiiquaJAGetatis
Ammonise, -or SpMf^l^^Minff#eru«,-'USu£aiy festfeGm-
ed only' as a gentle shdSrific,f^^ahdt aiSi«^ropriate''to
rheumatic disorders^ ^bri^ jia eonimmr ^old, is a mild

sedadvei \?thich, tt^hile produces g^tleidiapho- .
resis, abates the heat, tMrst;«‘and frequency bf pulse,
and is useful iil aD‘'diseases~ of -excited actions ‘when
not superseded by- inedfcines of higher power. *ri It is
given in draughts and‘jtd^S] combined occasionally With
nitre, camphire, ^d-otHfer'biedieines'," said m doseS of
half an ounce repeated^ from hour to' houf. ■' mu j A

Liquor CitTatis BbtaSssC, or the HaiMUte Ajpidum Cai-
boniciiin Evolvefts, 'the 'eff^vescciit ifeuught; Is,’ in 'many
inflammkorydisek^s, and ih aUTeversbr diseases accom-
panied with irritability of stOmacli and puMng, an admi^
rable sedative, in which is combined a portion of carbonic

b

20

NARCOTICS USED AS SEDATIVES.

acid, which, being evolved in the stomach, gently sti-
mulates it, and composes its irritability with that cool-
ing neutral salt which is produced by the union of the
citric acid with the carbonate of potass.

The AQUA ACiDi CARBONici, the simple aerated water,
or carbonic acid combined with water, is given in full
di’aughts, with lemon-juice and sugar, sometimes with a
slight tincture of wine. — Acetous acid, or vinegar, with
sugar and water ; the citric acid, or lemon juice, or that
of Tamarinds, are the more familiar sedatives, used less
formally than those salts wliich are ordered in the way
of extemporaneous prescription. These domestic or cool-
ing medicines make up the entire list of those sedatives
which are indisputably proper in the several varieties of
acute inflammation and high fever.

We advance now to certain medicines of the narcotic
tribe, which are prescribed with fear and doubt in in-
flammatory diseases, but which I hold to be infinitely
more useful, more powerful, more efficacious, in all cases
of danger, than those appropriate saline medicines. We
trust to the familiar remedies of nitre, tartrate of potass,
effervescent draughts, cooling drinks, and saline purges,
while the disease bears no character of danger. But it is
to tlie powerful narcotics that we have recourse, when in-
tense arterial action endangers some important organ !
when in Mania, or Phrenitis, or Hydi-ocsephalus, the vas-
cular action, as it rises or subsides, produces the most dread-
ful paroxysms of delirium, succeeded by temporary re-
missions ; when in Phthisis, a rapid pulse, beating at the
rate of an hundred and twenty in the minute, demon-
strates the violence with which the blood is driven through
the lungs ; when in Epilepsy one dangerous struggle
succeeds another with little intermission, day and night.

MIXED POWER OF NARCOTICS.

21

as often happens ; when in inflammatory gout, or in rheu-
matic fever, the paroxysms of pain return from time to
time, with intense throbbing of the arteries ; or finally,
when the Testicle is swelled with intense and sickening
pain, we have recourse to Digitalis, which moderates the
vascular action, arrests the thundering pulse, assuages
pain, and allays dehrium. No remedy is so powerful as
this, excepting perhaps nauseating doses of emetics ; but
the influence of emetics is too little permanent, whereas
by narcotics, we sicken and subdue, or, in plain terms,
poison the system, and keep down for a length of time
all vascular action. Vegetable narcotics are in these cir-
cumstances remedies quite invaluable, and too sparingly
used, for reasons which fall next to be noticed.

Of the class of narcotics there are individual medi-
cines, which have very various and mixed powers. In
wine and alcohol, in opium, hyoscyamus, and cicuta,
there are combined two distinct qualities, viz. a stimu-
lant and a sedative power. There is not a doubt, that
wine invariably, and opium very generally, exhilirates
first, and then intoxicates ; first excites, and then poisons
or subdues, all the actions of the system. But there are
others in which the two qualities are differently com-
bined ; as Cicuta, which fillet sickens, and then pro-
duces wild and maniacal delirium ; or Digitalis, whose
anodyne power immediately usurps the place of its sti-
mulant power, (if it have any stimulant power), whose
first effects are to sicken and subdue the system, and
depress the pulse from a hundred and twenty to sixty-
five ; while this, on the contrary, is the ultimate effect
only of opium, which, in the fii-st stage of its opera-
tion, stimulates.

From this variety of operation, arise the irresolution
and fear, with which the most prudent and wisest of the
profession give narcotics ; and thence is derived a natural ,
rule for the right administration of both. When we

22

OF THE CLASS OF NABCOTICS.

are to use opium, as often we do by way of cordial,
we give it alone, in siiiiall and .frequent doses; or we
combine it with sulphuric aether : it then excites the
senses' 'and the brain ; occasions heat, and restlessness,
and begets dreaming, ta: rather a waking state of exdte-
ment, approaching to delirium, and sometimes dehrium ;
and it reddens the surface, and makes it intolerably itchy.

These are- the effects of what is called an under-dose of
opiums Like; wine, its .stimulating property precedes its
narcotic power, but at last, and in large doses, it proves
•more immediately narootie ; sleep follows ; the senses are
steeped in sleep ; the patient wakens difficultly and
slowly, and tire LI pulse continues extremely slow and
languid; the senses continue obtuse ; the secretions are
suspended and u lessened ; the tongue and moutli ai-e
parched, and the* head aches and is confused. - When we
desire; without giving a fSttU do«e of- opium,. Jto profit by
its sedative power, twe combine it, with an equal proper-,
tion of hyoscyamus, or of digitalis..!, to
ui'The uses of these various Sedatives, saline and narco-
tiCj ’are detailed in the first pL ass of Extemporaneous
Pl^scriptions ; and it wdl be found, in the several pro-
cesses jfor the ciue of disease, tliat they have a peculiar
relation to affections pf the brain,

.ii< , / 'hi .» •

-iiOL Sbcont), Of Narcotics.

lid- _ tiiribi

Subduing incited action, or regulating it, is the chief
duty of the physician ; and the selection and right use
of narcotic drugs, an object of the very highest import-
ance in practice ; for these medicines command at once
the feelings and actions of the living system, whether
vascular or muscular ; and have, at the same -time, the
happy proj^erty of assuaging pain.

}f assuaging pain Avere, as is but too commonly ima-

THEIR NATURE DEFINED.

23

gwed, the chief property of such <lnigs, we should
think chiefly of opium, and reject all others as super-
fluous; for it is a medicine the most familiar by long
and frequent use, and it produces a pleasing, and tran-
quil, and quiet sleep. — But it is not so. Narcotics are
not anodynes merely ; this is not even the character of
the class. . x.The prcqjCTty common to all the tribe of nar-
cotics, and very conspicuously powerful in some, is that
of repressing incited action ; a property peculiarly pre-
cious! for narcotics, by abating pain, only alleviate
symptoms, but by arresting excited actions, whether vas-
cular or muscular, they contribute to the cure of diseases.

The properties of narcotics in the cure of disease, and
the right selection of them according to the nature of
the disorder, is best inferred from the manner in which,
when taken as poisons, they extinguish life, exciting,
in one stage, the wildesti delirium, and occasioning^ in
another, deep torpor, convulsions, slow breathing, and
oppression of all the vital functions, tiU \the person ex-
pires. And it is a fact most curious, that the effects pro-
duced directly, ' and in a few hours, by narcotic poisons,
are the same with those which are produced very gra-
dually, (though in the case of blows and wounds very
suddenly), by mechanical and organic disorders of the
brain, viz. delirium, convulsions, torpor, apoplexy, stop-
ping of the pulse, stertoi'ous breathing, and death.

Narcotics may be defined, “ Such vegetable drugs
(for none of the chemical class have the same powers)
as affect directly the sensorium and whole nervous sys-
tem, even t© the extinction of life, when taken by ac-
cident, or with evil intention, as poisons; but which,
prescribed in moderate doses, abate the sensibilities of
the body, produce a degree of torporj accompanied with
sickness, or even with convulsive motions, and retard
the actions of the heart and arteries.”

24-

selection OF NARCOTICS.

Narcotics, as they abate sensibility, are anodynes ; as
they allay excited pulsation, they are Sedatives ; as they
quiet muscular contractions, they are Antispasmodics. In
so much as they at once quiet muscular irritation, and al-
lay vascular action, they have great power over various
secretions, and thence they are usefiil as astringents ; and
by moderating vascular action through aU parts of the
body, and that during a great length of time, they
prove alterative, gradually extinguishing diseases of the
constitution, and assisting in the cure of sores, swellings,
and eruptions.

Of this class. Opium is the most familiar. Digitalis
perhaps the most powerful. When we reflect on the
uses our profession have made of these medicines, it
must excite a degree of surprise, that medicines possess-
ing such manifest power over all the sensibilities and
actions of the body, shoidd have been used only of late
years with confidence, discrimination, or skill. It is
within my own memory, that opium itself has been
freely used ; and it is only now, and in the present day,
that Hyoscyamus, Cicuta, and Digitalis, have been fami-
liarly prescribed. There was, for a time, no small dan-
ger of those precious medicines being left for ever in the
rank of poisons.

But, to enumerate somew hat more curiously the seve-
ral properties just ascribed to narcotics, will perhaps aid
the young physician in combining them one with an-
other, or in selecting such as are peculiarly suited to the
several kinds of disease.

OF THE PROPERTIES, AND SELECTION OF NARCOTICS.

It is to be observed and remembered above aU things,
that the narcotic property, however powerful in any
vegetable substance, is never pure, nor is it natural that

QUALITIES OF OPIUM.

25

it should be so ; for, composed as this exalted part of
the vegetable is of various principles, the narcotic virtue
is combined, and sometimes contrasted, with various
other powers ; — in some, with a stimulating property,
which proves cordial when the medicine is given in
smaller doses ; — in others, with such peculiar acrimony,
as prevents the stupor, and excites a high, wild, and
savage delirium ; — ^in others, with principles which excite
various secretions, especially those of urine and sweat.
It was the confounding of these properties, as arising
from one sole principle, that made it be believed, that
the stimulant property was the sole virtue of such
medicines, and the subsequent stupor a mere conse-
quence of the high excitement produced by the stimu-
lant power. Such reasoning gave a rational and philo-
sophical aspect to the Brunoniau doctrine, while in truth,
many narcotics, as Cicuta, produce savage and furious
delirium, not in the first, but in the second stage of
their operation ; many, as Digitalis, exert an immediate
narcotic power, without any previous or intermediate
state of excitement ; and all narcotics may be given in
such a deadly dose, as instantly almost to arrest the vital
motions.

Some narcotics, and opium in an especial manner,
have this separate and distinct stimulant power, but
subordinate stiH to the narcotic power ; so that the sti-
mulant power is hardly perceived before the narcotic
quality begins to operate on the senses and the cfrculation.
And we are able to profit by this distinct power: — Opium
heats the external parts to which it is applied, com-
forts the stomach, acts as a cordial, excites the brain,
and exhilirates even to intoxication or delirium : But in
a moment this delirium ends, the narcotic property has
time to affect the sensorium, and then comes torpor, sleep,
snoring, stupor, and slow oppressed pulse, apoplexy,' and

^() OF belladona and cicuta.

finally death, when the drug is taken in such quantity as
to prove a poison : or, if the person survives the slighter
degree apoplexy, or after a strong soporific dose
of opium, he feels confusion of the senses, an aching
head,--disordered stomach, and paralytic trembling of the
hands and limbs.

In the operation of other narcotics, no such stimulant
power can be perceived throughout the whole scale of
operation, from the safest and smallest dose, to the most
poisonous quantity. — Belladona, the deadly night-shade,
whose tempting berries often induce children to pluck
them, proves very immediately fatal. The child lies in-
sensible, breathing slow with a dilated pupil ; the joints
are flexible, the limbs quite paralysed, the pulse slow,
and the extremities cold; the stomach is paralysed,
so that it can no way be excited to; any but very im-
peidect action, and ineffectual .straifiings to vomit; and
when the child dies,«^the face is turgid and purple, the
tongue and lips swollen, and the body stained with
black and purple spots. 1 ht o-

Gicuta Hemlock occasions, as the first signs of dis-
order, not delirium, but vertigo ! heaviness of the
.senses, sickness, dimness of sight, dilatation of the pu-
pil, faultering of the tongue, paralytic trailing ctf the
limbs, and anxieties of the pr®cordia : If delirium fol-
lows, it is invariably after these first deep tokens its
narcotic powers ; and often the secondary operation of this
drug gives the lie to all the fancied processes of excessive
action and exhausted excitability. The person, after
having lain in a state of stupor during the first influence of
the poison, (taken perhaps by mistake for parsley leaves, or
the root of parsnip), after rising ineonsciously from bed,
after wandering in the dark through the house, in a con-
ftised condition, after striking furiously at every obstacle,
and beating his head in a delirious madness against the

OP STRAMONIUM.

27

walls, is found by neighbours or friends in the mornf
ing, livid fi*om innumerable blows^ bleeding at the nose
and mouth, and still raving and convulsed ; and this in-
sanity, produced by hemlock or other acrid narc*otics,
sometimes continues for months, sometimes for life.

Stramonium, Thorn-apple, the most powerful and fatal
of the narcotic poisons, one too deadly for internal use,
occasions very directly and instantaneously, vertigo, tor-
por, and death. A smaller dose has other effects : at
first, it throAvs the person immediately into a deep sleep
or stupor ; in a few hours he awakens from it, raving
with the most furious and fantastic imaginations ; he
has no power of utterance, and shews his passion chiefly
by the most wild and furious gestures ; neither sickness
nor {»in attend . its operation ; for several days the
patient raves, and gradually returns to reason, but ex-
ceedingly enfeebled, and unable to walk. When^used
with wicked intentions, the seeds of stramonium nare
usually steeped in wine, and given to the unwary:
Sharpers and robbers have been condemned for hav-
ing given this poison, committing their depredations
during the state of' intoxication which it produces and
procuresses, for exposing innocent girls while under the
influence of this temporary insanity, have been convict-
ed and condemned to death. The berries of the night-
shade, Avhich are often SAvaUoAved by shepherds and
country people for a frolic, six or eight at a time, produce
the same kind of intoxication and extravagant delirium.

We thus perceive,y that of narcotic vegetables, some
have their narcotic influence preceded by a stimulant
power ; others occasion first stupor, and then delirium ;
others are merely and purely narcotic, causing unmin-
gled symptoms of stupor^ blindness, and paralytic trail- '
jng of the limbs. MsThere is nothing, uniform or steady

the operation .pf narcotics, on Avhich to found the de-

28

EFFECTS UPON THE SENSORIUM.

lusive theory of their narcotic power being but the close
and consequence of high excitement ; they are visibly
and directly narcotic.

There is another description of narcotics, stiU more
interesting for medical purposes. Some narcotics, as
Belladona, affect directly and peculiarly the sensorium,
and system of the nerves ; others, and most especially
Digitalis, wliile it has comparatively slight influence on
the brain, affects more peculiarly the irritability of the
heart and arteries : By the use of this medicine, we
have it in our power, ivithout the sensorium being in
any way affected, to lower the pulsations of the heart
and arteries, in almost a fatal degree.

The qualities of narcotics are never simple, else they
would differ only in degree ! But the difference of more
or less, of being slightly or powerfully narcotic, is not aU :
the difference is essential ajid specific. Some narcotics
produce a deep stupor, others a wild delirium ; one
caus^ one kind of delirium, another a different species
of phrenzy ; one produces stupid drunkenness, blind-
ness, staring with dilated pupU, slavering from the want
of the power to swallow, while the person under the
temporary influence of the poison, feels as if moving
through clouds, or hanging suspended in the air ; as if
his head were ten times too big for his body ; or as if
his eyes were so enlarged, that no one could look upon
him without teiTor : And this last and singular sensa-
tion, this fear of alarming his friends by the monstrous
bigness of his eyes, the patient distinctly remembers
when his senses return. Others cause, after a short pe-
riod of stupor, a raging madness, anxiety of the prae-
cordia, gnashing of the teeth, the poisoned person biting
and lacerating his own arms and hands, in a raving and
terrible insanity. Other narcotics have still a different
operation ; instead of the sensorium being thus excited,

antispasmodics.

39

certain secreting organs are irritated ; Opium invaiiably
procures perspiration ; Digitalis invariably increases the
secretion of urine.

It is not surprising that narcotics, having such power
over the senses and the circulation, should also suspend
muscular actions, or, in other words, should prove an-
tispasmodic. As it is often our business, so to manage
the narcotic power, as to quiet local constrictions or
spasms without affecting the system at large, we natu-
rally set ^art certain medicines as a class, under the
title of ANTISPASMODICS. Narcotics are, ipso facto, or
in virtue of their universal influence over the nervous
system, Antispasmodics, or quieters of muscular con-
tractions ; they are the chief or only antispasmodics to
which we dare trust ; and those medicines which have
the appropriate name of antispasmodics, only because
they have no other conspicuous properties, are little
better than placebos : such are your musk, valerian, and
amber draughts, — the fashion of a day, — the unoffending
trifles which you prescribe for the languors and sickly
feelings of the nervous and hysterical The true anti-
spasmodics to which we trust for appeasing Asthma, or
spasm of the glottis, — Hydrophobia, or spasm of the pha-
rynx,— Gastrodynia, or spasmodic pains and cramps of
the stomach, — Colic, or spasm of the bowels, — Tenes-
mus, or spasms of the anus, — or Tetanus, and other uni-
versal convulsions, are not musk and valerian, but opium,
stramonium, and cicuta, mercury, ammonia, and blis-
ters.

Such various and peculiar qualities have been enume-
rated, as might leave on the mind a perplexed and in-
distinct impression of the effects arid uses of narcotics.
But, upon revising those various properties, we can re-
duce them to distinct classes, avail ourselves of the seve-

30

OF STIMULATING NARCOTICS.

ral powers, and appropriate certain narcotics to specific
purposes, and almost to particular diseases.

First, The stimulant power accidentally connected
with that narcotic which we most frequently use, viz.
Opium, is of veiy universal use ; though it prevents our
having recourse to this medicine in diseases of incited
action. ' f i-avs y ^

We know 'by’ experience, that we can derive no
soothing nor anodyne influence fi^m opium, nor pro-
cure sleep by its use,^ when the pulse is full and
strong ! for opium increases its fulness and strength,
and‘aggravates the 'suffering. In diseases of the head,
it aggravates the delirium ; in diseases of the skin, it
increases the heat and eruption ; in diseases of the joints,
especially in acute rheumatism, it aggravates the pain ;
ill peripneiirhony, it increases" the' dyspnoea almost to
suftbeatibn ! ’Tf,'Iih"any of these- dises^es^,^t^lraa5r be
safdy' admhiistered, it is either by combining ‘it* with
hy’oscyamus^ or' digitalis, or Accompanying it with a
nauseating dose of an emetic. uam .

This stimulant influence is the fimt operation of
which, ‘‘'^given in small and frequent doses,
warms, excites, 'and exhilirates, at least when it agrees
with' the constitution *, and thence, opium' is ^ useful
in'^ the muttering delirium of low fevers, in nervous
and^’ convulsive disorders, and in diarrhoea, dysentery,
and other abdominal diseases. But we find by ex-
perience, that we can reap little benefit from the nar-
cotic powers' 'of opium, after great and vital injuries hy
blows or flitls! after accidents ‘affecting the brain! or
after ' sui*gical operations ! The " patient] being ^ at such
time hv'full health and vigour, and little accustomed
with the use of opium, is usually^kept broad a^vake by it,
restless, tossing, and feverish. W e usually find him _in

OF SEDATIVE NARCOTICS.

31

the morning, sickened, with a quickened pulse, inflamed
eyes, and parched mouth.

Second^ The most precious quality of narcotics, is
that of allaying intense arterial action in acute diseases.
Where an accelerated circulation plays upon the struc-
ture of the brain, or of the lungs, or tortures the joints
with pain, increased by every throb of the arteries, and
by its force tries the strength of every smaller vessel ;
when it threatens such-, internal effusions as produce
death when they take place in the brain, suffocation
when in the lungs, and extravasation of serum and
gelatinous matter when they take place round the joints,
so as to stiffen, swell, and distort them, so as to affect the
form of the very bones, ^ and: cause a knotting of the
greater joints, and cmving and twisting the fingers and
toes ; In such diseases, we dare not use opium, but have
recour,se to Digitalis, wjhidi lowers the pulse as securely,
as quickly ,too, as if. wjBihad put the, finger on some main-
spring of the machine.;, or to Hyoscyamus, or to Conium
Maculatum, which are in some cases the best and most
harmless anodynes for, alle.viating pain. ibIk sfj »'

Thirdi Anoihev -happy combination, enables us, by a
right management of narcotics, to excite certain secre-
tions, among the principal of whic^ ,are, , those of urine
and perspiration.’,: Digitalis has itself the power, while
it lowers the pulse,qof exciting a profuse flow of urine ;
and thence, the cireplating system, and, all its secretions
is thrown into disorder : 9 Or wdien diseases of tho abdo-
minal viscera are accompanied with a dropsical effusion,
its combined, influenpe is more availing than all the
other articles of the materia medica. Opium has, in like
manner, the peculiar property of causing perspiration,
a property whicli is much improved by combining it
with emetics. , ,

Fourth, The property of narcotics next in import-

OF ASTRINGENT NARCOTICS.

ance, is that of relaxing spasm ; and for this, certain
narcotics are selected to accomplish specific purposes.
For abating general sensibility, and preventing the
spasms and intense paroxysms of hooping-cough, Cicuta
is found most useful ; for relaxing the spasmodic con-
striction of the glottis, which is the cause of asthma.
Stramonium, inhaled in the form of fumes or vapour, is
infallible ; for relaxing spasms of the stomach, or other
abdominal viscera, in cramps, colic, and ileus, Opium is
preferred ; in tliose diseases, its cordial influence is
manifestly useful, and forms a happy combination with
the narcotic virtue of the drug.

Fifth, The power of narcotics in restraining excessive
discharges, is very conspicuous, and very consistent with
their other virtues ; for these increased discharges, are
compounded of muscular irritability, by which the tube,
whether it be the urethra, trachea, or the alimentary
canal, is excited to increasing actions ; and of incited ar-
terial action, proceeding from this irritation, and pour-
ing into the cavity or canal an increased secretion. Thence,
we find, that in Catarrh, or common cold and cough, in
Mucous Asthma, in Gonorrhoea, in Diarrhoea, Dysen-
tery, and Cholera morbus, narcotics, and especially
opium, are of great efficacy, both in appeasing the irri-
tation, and in repressing the secretion, or rather exu-
dation of their fluids ; and by the same virtues, opium
is a sovereign remedy in Menorrhagia, Abortion, and
Child-bed Flooding.

Sixth, Another, and most useful property of narco-
tics, is, so to retard and moderate the general actions
of the system, that by continuing their use, and com-
bining them with other medicines, as mercury and anti-*

, mony, we resist or exhaust other peculiar actions, as
tiiose of Syphdis, or Cancer, and cure incipient schir-

OF ANODYNES.

33

rous disesses in the liver, testicle, salivary and lymphatic
glands.

Seventh, Lastly, having enumerated the various pro-
perties, of allaying incited action, regulating secretions,
relieving spasm, and other influences by which narcotics
assist in the cure of disease, we come last of all to men-
tion their anodyne qualities, by which they soothe irri-
tation, allay pain, and procure sleep, To this we resort
as our last refiige in all incurable diseases ; as in des-
perate gout; in that kind of rheumatism by which
the joints are stiffened, crooked, and swollen ; in cancer,
in malignant sores, in tumors which do not admit of ex-
tirpation ; in diseases of the rectum and bladder. — But
anodynes should ever be our last resort ; they should be
given habitually, only after we have ceased to prescribe,
when we merely give the patient leave to assuage his
pains, by using narcotics, especially opium, in such doses
as his feelings or suffering require. When this period has
arrived, we have indeed abandoned all hopes of cure, for
narcotics used as anodynes, and increased gradually as
health declines, so deaden the sensibilities and powers
of the system, that recovery is no longer possible ; for
it is as slow poisons, that narcotics suspend the sensibflity
and feeling of pain.

These are the various properties of narcotics ; and we
perceive, — that opiates will be often used as cordials, not-
withstanding the narcotic power with which their stimu-
lant quality is combined : — That opium combined with
digitalis, wfll be often used in acute and painful dis-
eases, as rheumatism and gout : — That opium combined
with emetics, will be often used in the beginning of
fevers, in agues, and wherever perspiration is required :
— ^That opium combined with mucilaginous medicines,
and mth camphor and ammonia, will be often used in ca-

voL. nr. c

34>

OF INDIVIDUAL NARCOTICS.

tarrh : — That opium will be peculiarly useful, when com-
bined with astringents, and alternated with purges, in
diseases of the alimentary canal : — That digitalis wiU be
prescribed chiefly in phthisis, delirium, madness, and
acute rheumatism, where we fear to prescribe opium,
lest it should raise arterial action, and increase the pain :
— That digitalis, in combination with squills, nitric oether,
and other diuretics, will be used in dropsy : — That hem-
lock, hyoscyamus, stramonium, will be used for relax-
ing the spasms of asthma and hooping-cough : — That
cicuta, in combination with mercury, will be used as an
alterative : — and that we shall very generally, after all
.hopes of cure are gone, return to the use of opium as
the safest and gentlest anodyne.

Here, under this order, are comprehended all the
more powerful articles of the materia medica ; and it is
according to these general characters, that the extempo-
raneous prescriptions must be arranged. But, before
suggesting to the young physician the various forms in
which these medicines may be best administered, it is
natural to give a short account of each individual of the
class of narcotics and antispasmodics.

OF THE HISTORY AND VIRTUES OF THE
VARIOUS NARCOTICS.

The individual characters of each of these may, after
this general description of their properties, be very’
briefly recited.

Opium.

Hyoscyamus.

Digitalis.

Conium Maculatum,

Belladona.

Stramonium.

, EFFECTS OF OPIUM.

35

^Opium, pap aver somniferum, is

the inspissated juice exuding from the capsule of the
Poppy, as it grows in Asia, Egypt, or other warmer cli-
mates. Its taste and overcoming odour announce its
powerful influence ; it heats the parts to which it is exter-
nally applied ; and in moderate doses, and with those
especially who are habituated to its use, it warms the
stomach, excites the pulse, enlivens the senses, sharpens
the wit, inspires a drunken and furious courage, produces
a slight and temporary intoxication, in which aU things
look cheerful and happy ; and, given in an under dose,
or firequently repeated, it keeps the patient broad a-
wake.

Opium, then, is to be used with caution and reserve
in all excited states of the vascular system, but espe-
cially in diseases of the brain, in delirium ferox never,
nor in phrenitis. There is no want of evidence of
its cordial and stimulant powers ; this is even a prime
quality in tlje medicine, which is accordingly used, as a
stimulant and cordial, in nervous alfections, and in low
fevers ; as a stimulant operating in the end as an astrin-
gent, in alvine fluxes, or in those from the uterus ; and
as a sudorific, when given in minute doses conjoined
with any emetic.

It is in the second stage of its operation, and when given
in larger doses, that we profit by the narcotic power of
opium. Opium is our principal medicine in all disorders
of the alimentary canal, whether as an anodyne, or as an
astringent ; or ip other terms, for allaying the irritated
actions of the intestinal canal, and for abating and mo-
derating the vascular action from which the profuse se-
cretion arises. In the approaching paroxysm of inter-
mitting fevers, and even in active inflammatory disease, as
Pneumonia, Angina, and even in Phrenitis, some have
adventured to give opium, qualifying its operation, and

c 2

36’

ENUMERATION OF ITS VIRTUES.

repressing its stimulant power, by combining it with
Submurias Hydrargyri, or with deeper narcotics, as
Hyoscyamus. Its truest narcotic effect is in its power
of appeasing spasms, as in tetanus, in locked jaw, in hy-
drophobia, and in convulsions, whether of the hysterical
or of the epileptic kind.

But the most comprehensive way of enumerating the
several virtues of this universal medicine is, to give a
succinct catalogue of its various combinations and uses,
as they appear in the table of extemporaneous prescrip-
tions ; always recollecting, that opium is stimulant
and cordial in its first operation, especially when
^ven in smaller doses, and frequently repeated, and
in those patients who have not been familiar with
the medicine : — In larger doses, and in those accus-
tomed to its use, it is a pleasing anodyne : — In its
largest doses, it proves a deep and deadly narcotic, pro-
ducing, in the first moments, a heavy sickness and vain
efforts to vomit ; the senses are buried in lethargic stu-
por, the whole body paralysed, and the patient dies apo-
plectic.

The dose of opium is from half a grain to three grains :
Four grains, or a little more, are sufficient to produce a
dangerous and lethargic stupor, in those unaccustomed to
its use, while a drachm often is taken safely by those who,
from extreme suffering, have been induced gradually to
increase the dose. Practitioners choose to boast of the
enormous doses they have ventured to give of this me-
dicine; but it is a poor matter to boast of; it is only
habituating one individual to bear a useless dose of a
narcotic, which ultimately ruins the neiwous system,
while another, who has been less coarsely dealt with,
reaps equal benefit from a very moderate dose. There
is little merit in augmenting the dose, without im-
proving the effect.

VARIOUS USES OF OPIUM.

37

It is impossible to display the various forms in which
this invaluable medicine is given, without anticipat-
ing many prescriptions arranged under the heads of
Cordials, Astringents, &c. But where is the harm of
anticipating, if anticipation be the best form of teaching,
what the young physician requires to know ? Anticipa-
tions are as unavoidable in a work like this, as pleonasms
and repetitions.

1^/, Opium is successfully used as a cordial, in pains
and crampish disorders of the stomach, combined with
alkaline medicines, as Ammonia, Magnesia, &c.

2c?, It is happily used as a cordial in fevers, combined
with Camphor, with Spiritus (Etheris Nitrosi, &c.

3c?, It is happily used as a gentle sudorific in continued
fever, combined with Spices, orwith Antimonial, Saline, or
Effervescent Draughts. Or as a very powerful sudorific
in the approach of intermittent fever ; for if given at the
approach of the hot stage, it produces a soft, refreshing,
and quiet sleep, followed by a profuse perspiration ; and
it brings the paroxysm to a regular and speedy close.

It is thus used as a powerful sudorific, not in in-
termittent fever only, but also in rheumatism, coryza, or
common cold, &c. combined with Ipecacuan, as is fully
explained under the head of Sudorifics.

5?^, It is used to alleviate pain, to abate vascular ac-
tion, and, by allaying action, to cure disease ; it is used
even in acute inflammatory disorders, as in Hepatitis,
Pneumonia, &c. ; but always conjoined with Submu-
riate of Mercury.

6t/i, It is used as astringent, in all abdominal fluxes ;
in dianlioea, cholera, dysentery, &c. combined with
Catechu, Rhubarb, Cinnamon, Alum ; as will be more
fuUy explained under the head of Astiingents.

7t/i, It is used in all haemorrhagic actions, as in hae-
moptysis, haematemesis, profuse menstruation, abortion,
or child-bed floodings, combined with Sulphuric Acid.

38

VARIOUS USES OF OPIUM.

8/7/ , It is used as an antispasmodic in cramp of the
stomach, in asthma, pertussis, &c. combined with Sul-
phuric CEthcr; and in ileus, volvulus, intus-susceptio,
&ic. combined ^nth Oils, Purgative Medicines, and Hot
Fomentations. ' ■ ;

Qtk, Opium is used as a powerful antispasmodic, in
combination vuth Camphor, IMercury, &c. in all the
more afliicting and fatal convulsions, as in tetanus, tris-
mus from wounds, catalepsy, hydrophobia, &cc. ; but
the singular condition of the system then demands the
largest doses ; from ten grains to a scruple or two
scruples of Opium are sometimes given.

loth. Opium, which is useful by its sthnulant power
in opening the secretory vessels, and promoting perspi-
ration, is useful in repressing the profuse flux of mucus
in catarrh, gononhoea, cystirrhoea, &c. by lessening that
sensibility and irritation, which continually excites the
mucous glands, and the exhalent vessels of the trachea,
to pour out their secretions.

nth. Opium is very frequently used as an anodyne.
To alleviate pain and relieve symptoms ; to quiet slighter
irritations, to prevent slight delirium ; and to ])rocure
sleep, are among the most frequent occasions in which we
use Opium ; and the form in which it is administered for
such purposes, is always the most simple and pleasing, viz.
a small pill, containing a grain or a grain and a half of
opium : or twenty, thirty, or forty drops of the tincture, in
a pleasing draught. In the excruciating pains of acute
disease, as rheumatism, gout, syphilis, &c, we conjoin
with it an equal proportion of the tincture of hyoscya-
mus, reinforcing one narcotic with another, as w^e do
one purge or emetic with another purge or emetic.

In almost all those diseases for which Opium is pre-
scribed, especially in disorders of the bow^els, when sick-
pess and vomiting prevent its remaining on the stornach ;

VIRTUES OF HYOSCYAMUS.

39

and always when we hope to allay general convulsions
by its narcotic power, we give large doses in the form
of glyster.

In many cases of acute pain, and in almost all acci-
dents, as bruises, sprains, and fractures, we prevent the
extravasation continuing, and allay the excited vascular
action, by embrocations of opium in the form of solution,
or tincture, or by applying soft opium to the part.

Hyosc ^amus NIGER, Henbane, is the

second narcotic in our order, though among the highest in
power. It produces, even in its fir st operation, a stupid
drunken-like torpor, with vertigo, dilatation of the pupil,
and paralysis of the features, delirium, vomiting, and
a slow oppressed pulse. It augments the secretions
of urine and sweat, and causes at once vomiting and
purging, whence it is suspected to be a prime ingredient
in the Eau Medicinale. The preference given by some
to this narcotic, is ascribed to its influence in relaxing the
bowels, while its real superiority consists in the total
absence, as far as we can perceive, of any stimulant
power ; in its being a pure and powerful narcotic ; in its
having that virtue which opium certainly has not, in
the first instance, viz. of allaying vascular action while
it assuages pain.

Hyoscyamus affects thejpervous, without exciting the
vascular system : — it is extremely useful in allaying pain,
in acting gently and propitiously on those irritable con-
stitutions, which cannot bear opium; and forms a valuable
addition to opium in qualifying its 6peration.-It is particu-
larly useful in phrenitis, in paroxysms of madness, in rheu-
matism, gout, and other painful disorders. Internally it
is best given in fonn of draughts, conveying from fifteen
to thirty or forty drops of the tincture ; or in the form
of piUs, conveying for a dose, from half a grain to two or
three grains, wliich dose may be given in gout, rheuma-

40

HYOSCYA3IUS EXTERNALLY USED.

tism, phrenzy, &c. up to a scruple or even a drachm !
Doses of tills magnitude have been given to counter-
act the excitement in intense and furious pai-oxysms of
madness, and sometimes they do prevent the febrile de-
lirium from rising to a fatal pitch.

This is a medicine used as yet too timidly, and
too little: It represses vascular action, assuages pain,
procures a profound and tranquil sleep, and a serene
and placid condition of the senses: Yet its use is

sometitnes followed by stupor, vertigo, and dimness
of sight, scabby pustules often arise upon the cheek
or chin, and round tlie mouth, and sometimes it
produces a profuse flow of urine, often diarrlioea, with
occasional tormina of the bowels. — In violent diseases,
the dose of Hyoscyamus must be increased to five or six
grains, before it has any very conspicuous effects : as an
anodyne, we begin with doses of three, and advance in
successive nights to six or eight grains ; it occasions less
heat, thirst, or low sickness, on the following day, than
opium, and it relaxes the bowels.

Cataplasms of the leaves of Hyoscyamus are applied
successfully, to abate the intolerable pains of Open Can-
cer ; and I can vouch for the powerful effects of the ex-
tract plastered upon foul cutaneous sores, scabby erup-
tions, and venereal ulcers of the secondary kind, in
suppressing the excited vascular action, and in healing
the idcerated surface ; for the same purpose the powder-
ed herb is occasionally scattered over the surface of in-
tractable sores, and its effects infinitely exceed those of

the CONIUM MACULATUM.

Digitalis Purpurea, Fox-Glove.

Tlie leaves of Digitalis have a bitter, acrid, poisonous
taste. This poison causes dimness of sight, vertigo, tot-
tering delirium, hickup, vomiting, and violent purging ;
paralysis of the features first, and finally of the whole

VIRTUES OF DIGITALIS.

41

body. Of our narcotic medicines, no one is so precious
as this, for none has such direct, immediate influence on
the vascular system ; none so instantaneously moderates
the action of the heart and arteries, without dangerously .
affecting the nervous system ; it needs but to be slowly
and cautiously increased in its dose, to depress the pulse
to any standard, and keep it so.

This power, viz. of moderating vascular action, con-
stitutes its most important and peculiar property ; but
another contingent and also invaluable effect is, its power
of increasing the secretion of urine. From this happy
combination of a narcotic property, capable of quelling
vascular action in a few hours, with a peculiar power of
augmenting the secretion of urine, and relaxing the
bowels. Digitalis ranks first in our catalogue of medicines,
as being active not merely in relieving symptoms, but in
curing disease. — There is no inflammatory disease, in
which it may not be safely and advantageously used,
and there are some to which it seems peculiarly adapted.
— It is ill a peculiar manner adapted to aU those diseases,
in which an excited and vehement circulation is press-
ing dangerously against the organization of some im-
portant organ : — In Phrenitis, in furious paroxysms of
Mania, and in Hydrocephalus, digitalis, combined with
sub-muriate of mercury, is an invaluable remedy :~In
acute Rheumatism and Gout, in Hooping-Cough, Croop,
and Spasmodic Asthma, it is a very valuable remedy :
It is above aU celebrated as having the power, like preg-
nancy, of suspending Phthisis, but I know few who wfll
have the boldness to say, it can cure the disease proceed-
ing from vomica, or suppuration of the lungs. — It is
useful also in Hsemorrhagies, by suspending the action
of the heart and arteries : — It is very useful in Exanthe-
mata, especially in Scarlatina, when followed by dropsi-
cal effusion, as often happens fatally in boys ; — It is the
specific for dropsy, whatever its species is ; and when

42

DIGITALIS DANGEROUS.

given in the form of tincture or infusion, slowly incr ease
ed, its diuretic effects supported meanwhile by drinking
continually of imperial, (viz. solution of supertartrite of
potass, made pleasant with sugar and a little wine), it is
so very efficacious, that I have in one week seen three
patients of various ages effectuaUy cured, the urine be-
ginning to flow, copious and colourless, from the first
day in which the medicine was given.

As an injection in Gonorrhoea, in irritable Bladder, or
in diseased Rectum, it is stdl a precious remedy: I

have found it particularly useful in cutaneous sores, le-
prous eruptions, and scabby blotches, — The infusion for
injection, or for internal use, is made by infusing a
drachm of the powdered leaves, in eight ounces of boil-
ing w'ater, for three quarters of an hour : For internal
use, an ounce of any aromatic water should be added to
this infusion, and from half an ounce to an ounce of the
mixture should be given twice or three times a-day. Of'
the spiritous tincture, from fifteen to fifty drops ; of the
powder, from half a grain to two grains three times a-day,
may be safely given. — A stronger infusion is made for
external application, in itch, leprosy, scurvy, and cu-
taneous ulcers. As an ointment, the extract is used,
rubbed down with a little oil, or mucilage, or the recent
juice.

While Digitalis is operating powerfully in dropsy,
there often ensues such irritation of the bladder, and in-
continence of urine, that the patient rises fifty times
of a night, straining ineffectually : hot fomentations,
and opiate glysters, appease this irritation. When sick-
ness and confusion of head, vomiting, and purging en-
sue, we must not merely moderate the dose, but ac-
tually withdiaw the medicine altogether, and give an
opiate, stimulants, as warm port wine negus, and dilu-
ents. Often, after Digitalis has lowered the pulse in a

dangerous degree, in diseases of the lungs or of the heart.

CONIUM MACULATUM.

43

the imprudently continuing the medicine, helps on the
disease to its fatal termination ; it should in such circum-
stances be withdrawn for a time, till the pulse rise, or
the pains or cough return. In Mania, Plwenzy, Rheu-
matism, Gout, &c. it can hardly be continued too long ;
in Phthisis, much more in mucous cough, or asthma, it
often should be interrupted, and sulphuric acid, cether
draughts, and cordial doses, viz. small and frequent doses
of opium, given in its stead.

— CoNiUM MACULATUM, Hcmloclc, is a power-

ful and pure narcotic, with a peculiarly oppressive and
poisonous odour, which certainly has in its combina-
tion, some more active and stimulant properties than
either Digitalis or Hyoscyamus ; for though its first
operation as a poison, is to induce vertigo, dimness
of vision, with dilatation of the pupil, faultering of
the tongue, paleness of the visage, trailing of the limbs,
and general paralytic relaxation of the whole body, and
of the sphincters, together with great anxiety and oppres-
sion of praecordia, and at last a deep apoplectic stupor ;
yet, from that apoplectic condition the patient often
awakens, into a state of fiirious, or at least of wild deli-
rium, terminating sometimes in madness.

Hemlock is a powerful anodyne, but by the caprice of
fashion, has been used as such, only of late years : hemlock
piUs are now prescribed in every exigency. — Hemlock has
little influence in exciting any secretion, but it has much
effect on the pulse, which becomes slow and heavy under
its use.-^It is found universally useful in painful diseases
of the bladder and rectum, in rheumatism and gout. — It
has most happy effects in arresting the growth of indu-
rated scrophulous glands, of the indurated prostate, and
especially of swellings of the testicle, threatening schir-
ms. — It is a perfect Antipsoradic, and assists in the
Jjealing of scrophulous, syphilitic, and carcinomatous

t

44 HEMLOCK AS AN ALTERATIVE.

sores ; and in hooping-cough it is found very efficacious,
especially in children.

Formerly cicuta was used, not as an anodyne, but as
an alterative only. Pills of the powdered leaves, con-
taining each three grains, are useful anodynes, one or
two being given at fust in a dose, according to the exi-
gence of the case, and gradually increased : The same
piUs repeated three or four times a-day, moderate the
hooping-cough, or cure it : The same piUs, combined with
two grains of sub-muriate of mercury, given two or three
times a-day, and gradually increased, prove useful in glan-
dular tumors, in schirrous testicle, in chronic complaints,
and in preventing the increase of schirrous mamma :
The same dose gradually increased, is powerful in scro-
j)hulous, syphilitic, and carious sores.

For each grain of recent powder wliich a patient is in
the habit of using, a grain of fresh extract, or inspissated
juice, may be used ; and in any or all of the above-men-
tioned diseases, the dose may be gradually increased to a
scruple, or even to two scruples. — The medicine should
be made to affect the sensorium slightly, and there is no
limits to its use, but the excess of that vertigo, sickness,
and dimness of sight, wliich it peculiarly produces : An
inspissated juice drawn from the seeds, has effects much
more powerful than that from the leaves.

Externally, the extract or inspissated juice of the Co-
nium maculatum is used as a plaster to scabby erup-
tions, or cutaneous ulcerations ; the recent powder to
sores ; a fomentation of the boiled powder, or fresh leaves,
is applied hot to indurated glands, or to open cancer ;
and the powder mixed with axunge, is used as an antip-
.soradic ointment, which in a few days, and without dan-
ger, quite extinguishes the disease.

Atropa belladona. Deadly Night-
shade. The berries of the deadly night-shade are very

ATROPA. — BELLADONA.

45

tempting to children, and are a subtle poison. — It is at once
a powerful narcotic, and yet by its acrimony it excites the
secretions of urine, and perspiration. When taken in poi-
sonous quantity, the child dies with the mouth and fauces
excoriated, and the lips and tongue black, and swollen. —
It is chiefly an infusion of the leaves, or an inspissated
juice, that is given, though rarely in medicine ; and the
chief impediment to our unconstrained use of it is, the
inflammation and swelling, sometimes accompanied with
Ptyalism, which it brings upon the tongue and fauces. It
is useful chiefly in gout, rheumatism, phrenitis, and ma-
niacal paroxysms, and in cancerous and* syphilitic sores.

If given in substance, i. e. in powder of the dried
leaves, (the whole plant as well as the berry being nar-
cotic), it is best triturated with a little sugar, and tar-
trite of potass, so that it may be divided into very small
doses ; to a child, a quarter of a grain may be given, and
increased to two or three grains in the day ; to an adult,
from one to six grains.

The infusion is a still more manageable form ; it is
made by infusing half a drachm of the dried leaves in a
pint of boiling water, of which, when cooled and strained,
the dose may be an ounce daily ; and it may be increased
gradually, till the physician is either satisfied with its
effects, or alarmed by the irritation and swelling of the
tongue and throat.

The leaves of this, as of all the powerful narcotics, is'
applied to cancerous and ill-conditioned sores, either in
form of dried powder, or of the leaves simply moistened,
and mashed down.

Datura stramonium, Thorn-Apple, is

the most powerful and suddenly fatal of the narcotic
poisons : it occasions directly vertigo, torpor, and death ;
it is used in rather a more minute dose than BeUadona, viz.
a quarter of a grain, or half a grain, of the powdered leaves

. DATURA STRAMONIUM.

■ 46

or seeds : — it is reported to be exceedingly powerful in
curing melancholy and madness : — its best effect is not in
mania, or delirium, in which diseases other narcotics are
preferred ; but in another form, and in a different dis-
ease, viz. in the fonn of smoke from the dried leaves, in-
haled during severe paroxysms of the spasmodic, or even
of mucous asthma. While inhahng this fume, the pa-
tient feels his eyes grow dim ; every object seems to
turn round ; his eyes seem to himself to dilate to a fear-
ful size, as indeed the pupil does dilate ; he sickens, and
falls down in his chair, and sometimes vomits : he lies
thus with his chin upon his breast, insensible, and star-
ing wide, and the rima glottidis seems, in the same pro-
portion, to gape : he feels as if his throat were quite
open, as if breathing through a direct hole or wide open-
ing, rather than through a tube ! and is for the moment
relieved. But it is a painful resource, useful only in the
most dangerous cases, and which aU that I have seen
try it have soon abandoned. Stramonium and Tobacco,
are more properly to be ranked with Antispasmodics,
than with Narcotics. These are all the powerful narco- '
tics yet in common use.

HISTORY AND VIRTUES OF ANTISPAS-
MODICS.

(Ether Sulphuricus.
Camphor.
Ammonia.
Ipecacuanha.

JMusk.

Valerian.

Assafoetida.

Antispasmodics we can no otherwise define, than as
“ Narcotics given to oppose spasm as anodynes are

OF ANTISPASMODICS.

47

defined, “ Narcotics given to assuage pain.” The name
originates from the intention in which they are given,
not from the nature of the drugs, which are still the
same, still narcotics.

Antispasmodics then, are narcotic drugs, given to
abate inordinate action, not in the vascular system, but
in the muscular fibre, and chiefly in the muscular fibres
of the hollow viscera ! in the muscular fibres of the
glottis, of the stomach and bowels, of the neck of the
bladder! but rarely in the muscles of voluntary mo-
tion ; for the disorders of tetanus, trismus, epilepsy, and
other general spasms, are comparatively rare.

Of this class of medicines there are two divisions,
Antispasmodics and Placebos.

First, The true and efficient antispasmodics, which be-
ing possessed of high narcotic properties, rank with the
class last described. We should not trust the relieving
of cramp in the stomach, of dangerous spasm of the
colon, of spasmodic contraction of the pharynx, hydro-
phobia, asthma, nor locked jaw, suppression of urine
from spasm, nor of any other urgent disease, to those
medicines pecuharly named Antispasmodics : but to
opium only, or hyoscyamus, or camphor, or oether.
And it is to be remarked, that as an antispasmodic, the
stimulant and cordial powers which we distinctly per-
ceive in camphor, as in opium, are no hindrance to their
use ; for the purpose in the diseases just recited is, by
lowering the sensibility and irritabihty of the system, to
interrupt a muscular action which is altogether local,
and no way connected with vascular action nor with a
febrile pulse.

The second order comprehends such medicines, as
have only in a very inferior degree the same properties,
and which, not venturing to rank as narcotics, we name
Antispasmodics, or rather they are such medicines as

48

CETHER SULPHURICUS.

we familiarly prescribe in the harmless faintings of deli-
cate women, in hysterical paroxysms, in transient head-
achs, stomach disorders, and other nervous diseases, as
they are named.

Valerian powders, nervous pills, and draughts of musk
and amber, are so inert as to be little better than a mock-
ery. Such medicines are assumed into our materia me-
dica, not for any serious purposes, but to swell out the
catalogue of our dings, and amuse the distempered,
rather than cure the diseased ! to afford ‘placebos, which
cherish the hope of bemg relieved by strong-smelling
draughts. — Valerian, musk, assafoetida, and camphor, are
the chief in this division : Their high sensible qualities,
and overpowering influence over the senses and the
nervous system, would lead us to expect important ef-
fects ; but we know by impartial experience, that they
are of little value, of none in the opinion of those who,
engaged in the navy or army, or m curing the diseases
of warm climates, have to do with disorders which ad-
mit no trifling and no delay. — Let us at least speak sin-
cerely and plainly to one another, if not to the world of
patients ; and cleave fast to the powerful narcotics, es-
pecially to opium, whose sthnulant properties can, in
this intention at least, do no harm, but rather be of
use.

(Ether Sulphuricus. — If a practitioner

were desired to name a medicine, specific as it were against
spasm, or intense muscidar contraction, he would name
cether. Its operation is one example of the highest stimu-
lant power being no impediment to the use of a medicine,
M^hich is yet effectually narcotic, dither is effectually
nai’cotic, since we find (Ether drauglits, like Camphor
draughts, compose a patient under the delirium of fe-
ver, and procure sleep; and yet both operate as cor-
dials in cases of lowness, and as exciting powers when

LAURUS CAMPHORA.

49

given in small and frequent doses. (Ether is the best
and purest antispasmodic in diseases merely local, espe-
cially in pains of the stomach, and in the paroxysm of
spasmodic asthma. Given in the moderate dose of thirty
or sixty drops, viz. a drachm only, it is merely cordial,
and exhihrating ; but given as it has been by empirics*
in accumulated doses of two drachms, half an ounce*
or an ounce, it produces the happiest effects, in relieving,
and sometimes in actually curing asthma. It must, as
in the several examples marked in the following Section
of Extemporaneous Prescriptions, be always much di-
luted. Often it is most happily combined with anodyne
or cordial draughts, to prevent vomiting; and often
•with camphor. There is no medicine preferable to this
in paroxysms of hysteria.

Laurus Camphora. — Camphor is

now regarded not so much as a peculiar substance, but
rather as a peculiar vegetable principle, diffused in many
plants, separable from aU essential oils, but found most
abundant and pure chiefly in the leaves, and in the in-
terstices of the woody fibres of the Camphor Laurel,
a shrub which grows in great abundance in the islands
of the Indian Archipelago.

Camphor is a concrete, oily, resinous substance, shin-
ing, brittle, very friable, and volatile ; having a pene-
trating fragrance, resembhng that of rosemary, and a
warm penetrating taste, like that of peppermint. Its
stimulant, cordial, and antispasmodic effects, are chiefly
conspicuous ; its anodyne chiefly in composing to sleep
in febrile diseases, where opium proves unsuccessful ; and
in maniacal paroxysms, where to be useful it must be
given in large doses : In allaying the pains of rheuma-
tism and of sprains, and in preventing the extension
of ecchyrnosis, it is our most frequent embrocation.

Camphor, like opium, warms and excites the body,

VOL. HI. D

50

OF THE VIRTUES OF CAMPHOR.

when given in small and frequent doses; proves s
cordial to the stomach, allays sickness, and supports
the vis vite ; and it happily, at the same time, as-
suages pain, whether external or internal, abates the
delirium of fever, and moderates the pulse, prepares
the skin for perspiration, and procures a cool, re-
freshing, and gentle sleep. It appears to me to affect
the sensorium, and the vascular system, distinctly and
differently ; for while it exerts a pleasing and cordial |
power, in supporting the nervous system, it plainly mo-
dei^es the actions of the vascular system. It seems
better adapted to diseases of high inflammatory action
than opium, and is useful in conjunction with opium, to
temper its ill effects.

But the qualities of every drug are best described, in
enumerating the various disorders in Avhich experience
teaches us to use it. CamphOi', kii pains and cramp of
the stomach, in syncope, debility, and irregular hysteric
sytnptoms, is found to be, in moderate doses, a most
efficacious cordial. — In fever, it is also a precious remedy,
softening the pulse, abating delirium, and procuring
gentle sleep. — In inflammatory fever, attended with lo-
cal affections, as in pleuris)^', peripneumony, angina,
scarlatina, measles, and other eruptive diseases, accom-
panied with a hard and frequent pulse, it is also exceed-
ingly useful: — It softens the pulse in low fever, with mut-
tering deliriurii; and supports the vital powers by its
kindly influence on the ner\mus system. In intense ,
headachs, cephaleea, and mania, it is found to be a power- I
ful sedative ; but, to make it so, it must be given in the
largest dose, viz. from two scruples to a drachm, in the
course of the day, administered in doses of ten or fifteen
grains ; and to make this proceeding safe, we must watch
the patient to stop the course of the experiment, as soon
as we perceive that the medicine produces sickness, gid-

OF THE VIRTUES OF CAMPHOR.

51

diu€!ss, and coldness, anxieties, and fainting, for if im-
prudently continued, wild delirium and convulsions en-
sue. Such signs of danger as the first of these, are to
be regarded as the signal for washing out the stomach
with diluents, and strong emetics, and giving opium,
which best counteracts the ill effects of. camphor. In
paralysis, camphor is found useful by its cordial in-
fluence on the nervous system, moderating, and at the
same time regelating the pulse.

' In epileptic and in child-bed convulsions, we find
strong doses of camphor, viz. from eight to ten grains,
repeated every four hours, have a happy effect : and its
antispasmodic virtues are more familiarly useful in
the strangulation, and suffocating struggles of hysteri^
when the paroxysms ^e violent and protracted : cam-
phor has likewise been used, though wdth very equivo-
cal success, in hydi’ophobia, and in animal poisons, as
the bites of snakes and serpents.

Its anodyne powers are very useful in various disor-
ders of the urinary passages, private parts, and rectum,
given in the form of emulsion, along with nitre or spi-
i;itus oetheris nitrosus. It aUays irritation of the bladder,
and tlie frequent desire to pass urine in dysuria ; it takes
off the ill effects of blisters, or of the tinctura lytta?,
given in too great a dose ; it subdues painful erections in
virulent gonon hcea, especially if to the camphor draught,
or emulsion, be added a poultice or embrocation of it
externally ; it lessens also the intolerable irritation pro-
duced by piles, and tumors of the rectum ; and it is
useful in inflammations of the kidney, whether idiopa-
thic, or from falls or blows.

The power that camphor possesses, of soothing and
abating irritation, surpasses that of opium ; and thence,
in inflammatory diseases accompanied with spasm, as in
suffocating catanh, and asthma, camphor draughts., and

D 2

' EXTERNAL USE OF CAMPHOR^

juleps, are found extremely useful ; and in abating sa-
livation, opposing the power of mercury, and on various
occasions of irritation, it is extremely profitable.

Camphor is thus, by its cordial and sedative qualities,
by lowering the pulse, and at the same time, (to use the
phraseology of our forefathers), comforting the brain, a
very universal medicine.

Camphor externally in form of embrocation, dissolved
in alkohol or in wine, whether alone or combined with
opium, is a very useful application. By moderating
vascular action, it prevents the extension of ecchymosis
in bruised parts ; it assuages pain in sprains, and other
injuries of the joints ; it is useful in rheumatism, not |
merely (like ammonia) as a rubefacient, but as an ano-
dyne : as an anodyne it is also useful in cynanche ; in oph-
thalmia, it is a valuable ingredient in the best collyria
and ointments ; and in partial gangrene, it is of eminent
service, by correcting the foetor, and moderating the
vascular action, so as to favour separation of the diseased
parts from the sound ; and finally, in the itch of chil-
dren, it is the best and most cleanly antipsoradic, to
w'hich it may be advisable occasionally to add a mode-
rate proportion of the murias hydrargyri ; or the child
may be anointed with camphorated oil, mixing two
drachms of extractum hyoscyami with the ounce of oil.

The dose of camphor is of course proportioned to the
occasion. As. a gentle cordial and sedative in fever,
from tw'O to five gTains, repeated three or four times a-
day ; in mania, convulsion, hydrophobia, or tetanus,
from ten grains to fifteen, or a scruple, repeated every
tluee or four hours.

Ammonia. — The volatile alkali, whether ^

in its caustic or in its carbonized state, whether diluted in
the form of aqua ammonia, or in the solid fomi of crys-
tallized carbonate, is a useful antispasmodic and ar.o-

VIRTUES OF AMMONIA-

53

dyne. The aqua ammonia puRiE, or caustic solu-
tion, may be given in doses from ten to twenty drops :
the AQUA CARBONATIS AMMONITE, in doses of sixty
drops, a tea-spoonful or more : both require to be veiy
largely diluted, their properties are entirely the same :
A spoonful of hartshorn given at going to bed, in a cup
of water, often procures sleep, when opium fails : the
same draught taken at the approach of an asthmatic pa-
roxysm, proves a powerful antispasmodic : a linctus or
oily draught with ammonia, taken from hour to hour in
suffocating catarrh, or in the inflamed and spasmodic state
of the glottis, is a very useful medicine : a pill of carbon-
ate of ammonia, from three to five grains, with conserve of
roses, occasionally repeated, is an excellent prescription
in pain and acidity of stomach, or in syncope, or as a
stimulant in palsy, and hemiphlaegia : and the embroca-
tion of aqua ammoniae and oil to surfaces, where the
deej^er parts are inflamed, as in cynanche, rheumatism,
sprained joints, or inflammations of the glands or vis-
cera, is a universal prescription. — ^Ammonia has, in the
East Indies, been found to be the best resource against
the fainting, sickness, and other mortal symptoms caused
by the bite of the Cobra di Capella, Cobra manil, and
other deadly serpents.

Ipecacuanha. — Cephaelis ipecacuanha

i is an emetic used for various purposes, but in no pro-
: perty is it more valuable than when used as an antispas-
i modic ; and it is successful chiefly in that which, of all
i muscular contractions, is the most diflicult to resolve or
I prevent, viz. in that spasm of the glottis, which causes
the asthmatic paroxysm. Given as an emetic over night,
in a full dose, to those subject to asthma, and dreading
a paroxysm, it has many happy effects ; by sickening, it
appeases at once every animal action, and paralyses for
tlie moment every muscle : by exciting vomiting, it

\

54

IPECACUANHA AS AN ANTISPASMODIC.

empties completely the bronchi®, and all the mucous
follicles : by exhausting, it induces a gentle untroubled
sleep, and thus anticipates and prevents the approaching
paroxysm : and by causing a proftise perspiration, it of-
ten removes that catarrhal affection, which had revived
the habitual asthmatic difficulty of breathing. — As an
antispasmodic, its operation is greatly aided, especially
after a full dose, by giving presently a di-aiighf of lau-
danum, or of hartshorn, or of camphor and opium coin-
bined. Given in a lesser dose, viz. of three grains at
bed-time, though it produces but a slight sicknessj^'or
perhaps no obvious effect, it yet operates as an antispas-
modic, and prevents the asthmatic paroxysm. It is, from
this property, of singular efficacy in moderating the
hooping-cough, for which purpose it is given to children
in small doses, mei-ely sickening, or slightly emetic.

Musk, castoreum. — The highly

odorous secretion contained in the mucous follicles
near the anus of the beaver, is a substance, which
makes such singular and strong impression on the
sense of smell, that we are disposed to expect pro-
perties equally singular, and a power over the ner-
vous system proportioned to this impression. — But
v/hether it really is an inert medicine, or that its odour
is so diffusible, that a small proportion of it impreg-
nates very powerfully whatever vile substance the
dealer chooses to cheat the public with, so it is, that our
high-raised expectations have t^eh aU along disappoint-
ed, and this drug is now little better respected than
mummy, or album gr®cum, hr any other rejected or
obscene article of the older phamiacopceists. It is now
ridiculous to analyse, or praise, or any way to rely upon
it, and yet we must continue to rank it among our an-
tispasmodics. The frauds are notorious, so much we
iiiUjt say for the possible virtues of this dmg : Gums and

MUSK, valerian, and assafcetida. 55

resins highly scented, and a little mixed with musk, are
crammed into the scrotum of a goat, and sold as musk-
pods, and the frauds have become more daring, in pro-
portion as the animal becomes rare. No one now pre-
scribes musk with any interest or expectation: when
prescribed, it is in the form of powder, or bolus, in doses
of eight or ten grains. It is usually prescribed in hys-
terical disorders, with camphor, or a little opium, to give
some value to this strong-smelling di*ug.

^Valeriana oiFiciNALis.-r-The

fibrous root of valeiian dried, and reduced to pow-
der, is another drug formerly in high repute, and
remarkable for its obvious qualities of a strong cam-
phor-hke smeU, and aromatic bitter taste. Lake
musk, it seems ppweifujl, is innocent, has formerly
been much praised,,, and is a good ostensible medi-
cine in Hysteria,, and other* disorders, in which we
know not what else to give. It is must familiarly pre-
scribed in hysterical cases, and in Chorea Sancti Viti,
where it is afiBrmed to have very often effected a cure,
only perliaps because the disease is one which, at a
particular period of life, spontaneously ceases. It is
much valued and prescribed by some as good in Epilepsy,
a disease so desperate, that we are safe in affirming, that
this trivial drug never even contributed to a cure : it is
more likely to be serviceable as an anthehDintic. p,
Valerian is given in draughts or powders; the feast
dose should be fromofifteenf^ grains, pr ^a^ scruple, tQ a
drachm or more ; but it is so innocent, should 5ay ra-
ther so inefficacious a medicine, that patients yeiy cre-
dulous, and very desirous of benefiting by it, have taken
it to the amount not only of manyp,drachms, but,.qf se-
veral ounces in the^day. ^

AssAFtEXiDii^ — The gum-resinous juice,

exuding from the roots of the plant ; its smel is prover-

56

EMETICS AND PURGES,

bially powerful, and offensive ; its taste acrimonious and
bitter ; it is used in the form of pills, and chiefly as an an^
tispasmodic in asthma, in doses of a scruple or more. In
Dyspeptic complaints it is found warm, and cordial to the
stomach, and slightly affects the bowels. In hysterical pa-
roxysms, and suffocations, it is best used in the form of
glyster, two drachms or more being dissolved, or rather
mixed Avith four ounces water, so as to form a milky infu-
sion, which is administered warm. Such are theoccasions
in which Assafoetida is used ; but in my mind, this is cme
of the most palpable of all the occasions in which we are
cheated by the spfecious semblance of strong and obvious
qualities, into the belief of a medicine having some extra-
ordinary poAvers, while it is merely foetid and disgusting,

lOjir 8L

THE HISTORY.iOF EMETICS AND PURGES.

T

It is not merely, as medicines procuring various de-
grees of evacuation, that we class these together ; but as
medicines imtating and exciting the several po^jtions of
the alimentary canal; and hence, by sympathy, af?
fecting the whole sysjtem.

‘ ,'jjj Qp emetics,

Ipecacuanha, Zincum,

Anthemis Nobilis, Scilla Maritimai,

Antimonium, Sinapis,

^ '

Are the chief ; and, according to the dose, the man-
ner, or the combination in Avhich these are used, various
important purposes are effected. We use emetics,
m ordinary doses, and purely for the purpose of emp-

VIRTUES OF EMETICS.

57

tying the stomach : — 2c?, in enormous doses, when
either we are in haste to procure the evacuation of a
mineral poison, as Arsenic, or wlien the sensibility of
the stomach is so depressed by some dangerous narcotic
poison, as Opium, Cicuta, &c. that the largest dose of
an emetic hardly suffices: — 3c?, We use various emetics
in lesser doses, such doses as sicken and depress the
patient, and keep down all the vital actions : It is thus
we subdue the pulse in continued fever, and stop the hae-
morriiagic action in discharges of blood from the surfaces
of the stomach, and lungs, and uterus 4?/?, This is
the true theory of that remarkable effect so justly as-
cribed to emetics in diarrhoea, and dysentery ; it is not
by inverting the peristaltic motion, for the antiperistal-
tic motion, as it is called, of vomiting, never is excited ;
but the emetic, as a poison in nauseating doses, lessens
the irritability of the whole body, checks the action of
the arteries as much as it paralyses the muscles, and, by
lessening the irritability of the system, stops the disor-
derly and uiitated action of the bowels : — 5th, By com-
bining emetics with opiates, we procure a suspension of
that febrile action in the extreme arteries, which is so
unpropitious to secretion, or exudation ; and then, by
the exciting power of the opium, administered in a
small dose, we procure a gentle diaphoresis, and stop
the paroxysm of intermittent, or accelerate the crisis
of continued fever. Qth, Among the uses of emetics
given in full doses, it must not be omitted, that besides
compressing the hepatic system, and accelerating its cir-
culation ; besides squeezing the gall-bladder, and emp-
tying its ducts, and assisting occasionally in disengaging
biliary calculi, powerful emetics have anotlier very sin-
gular and important effect, viz. the promoting absorp-
tion ; for I have often been called into consultation,
when digitalis, and all other powerful diuretics, had been

58

VIRTUES OF IPECACUANHA.

unsparingly, but ineffectually used ; yet, a powerful
shock and excitement being given, by the administra-
tion of a very ‘strong emetic, -- or a drastic purge, that
moment, along with the watery stools, the urine has
begun to flow profusely.

Emetics formerly so familiarly, and by some periodi-
cally taken, for sick headach, or the female headaohs of
menstruation, is now never used for such a purpose;
indeed, hardly any thing could be imagined in the form
of a remedy, more truly dangerous and propostei^ous^p,,

Ipecacuanha caleicocca. Ipecacuanha

Cephaelis, ipecacuanha. — The root is of a nauseous bit-
ter acrid taste, and in whatever dose administered, from
three to thirty grains, excites the stomach to copious vo-
miting, preceded by severe sickness. In a full dose it
jHX)ves emetic, jin small and frequent doses it proves anti-
spasmodic, sedative, and sudorific. — As an emetic, ipeca-
cuanha is preferred, when the purpose is to.evacuatefhe
contents of the stomach, and that quickly,! as in crapula,
sickness produced by particular or unwholesome fbpds,
or in case of poison : Or when the purpose is, to empty
the biliaiy duets, compress the viscera, promote their
circulation, and to favour in dropsy the operation of, di-
gitalis or other diui*etics : — Tlris also is the emetic given,
.when the purpose is to empty the bronchi* of accumu-
lated mucus, to promote difficult expectoration, or to
prevent the more violent and dangerous paroxysms of
the hooping-cough jfi Or, when the purpose is, to resolve
indurations of the- lymphatic glands of the neck, to pre-
vent the suppuration of a buboe, or to discuss a swelling
of the testicle: — This is the emetic to be preferred, when
it is purposed to stop the excited action of the intestines,
and to /begin tlie jcure of diarrhoea, as in a child, by an
emetic. Ipecacuanha is also preferred, when our pur-
pose is, to anticipate the paroxysm of an intermittent

Dover’s powder.

59

fever, by giving a scruple of Ipecacuanha an hour be-
fore, or just on the appearance of the paroxysm.

For these various uses Ipecacuanha is prescribed in
doses of fifteen grains, which yet sometimes fail ; or of
a scruple, or twenty-five grains, which is certainly to
be reckoned a full dose ; but when we would make sure
of tbe effect, a grain or more of tartrite of antimony is
added to thirty grains of Ipecacuanha, and the whole
being so quickly (in six, eight, of ^en minutes) rejected,
and beins washed out clean with 'warm water, there is
no fear of any excess in its operation. '3 ^ ^ —

■WTien the intention is to arrest the peristaltic motion
of the bowels in dysentery, to check that irritation of
the trachea, and flux of mucus, which continues So long
distressing in severe ^or in chronic catarrh ; wheh we
wish to sitbdue ’vascular action in hasmOrrhages fi-Otil the
womb, or surface of the lungs, of stomach;'’ we 'Combine
the ipccacuknha with ‘magnesia, sugar, &cc. in^ fohn of
powders, or lozenges, and ^ve it ill minute doses of two
grains repe^ed from hour to hour. '

But the most valuable preparation > of this medicine,
that in which its emetic power is counteracted by
opium, is, the Pulvis Doveri, or pulvis ipecacuanhae
compositus, which is a convenient combination for
prescribing these two medicines, either in minute
doses, from hour to hour, in hEefnorrliages, ‘ or in’ fe-
ver; or for prescribing a full dose as a sudorific and
anodyne, in diarrhoea, dysentery*, menorrhagia, Of threat-
ened abortion. Six grains of the pulvis doveri, repeated
every two hours, is a valuable sedative. In rfieumatism,
in common cold, in continued, and especially in ca-
tarrhal fever, a scruple given at bed-time, in form
either of powder or of bolus, proves a powerful sudorific ;
a scruple, however, is in irritable constitutions,' and in

60

CHAMOMILE.

the young and healthy, apt to excite vomiting, espe-
cially if the patient drinks after taking his dose.

Anthemis nobilis, Chamoemelum, Chamomile, has
a coarse, strong, bitter taste, nauseous to almost every
one, but to a few very acceptable. It is by some prac^
titioners substituted to the more agreeable bitters as a
stomachic ; by many it is prescribed in intermittent fe-
ver, as a substitute for the Peruvian Bark. It is chiefly
employed as a hot stimulant fomentation, but is men-
tioned now for the only quality that is really admirable,
viz. as a gentle emetic in slighter disorders of the' sto-
mach, and oiM^ Especially acceptable to those afflicted
with bile and bilious headach, c«r diarrhoea. A cup of
warm chamomile infusion, is a gentle and excellent eme-
tic ; such a cup of infusion, is ^Iso prepared for those
who take ipecacuanha, who, if its operation be delayed,
wash it off with this infusion. ,rroii i ,\fj' lu, A

— ^Antimonium, Antimony, is an eme-
tic infinitely more various in its operation tlian arty other,
and many ways useful. It is represented to the imagina-
tion of the student in medicine, as an emetic, a purgative,
a diaphoretic, an antispasmodic, a febrifuge f without the
essential property being once mentioned, on which these
several virtues depend. — It is a sedative ; — ^it has con-
spicuously the power of subduing all the motions and
active powers of the" human body *, and I can no other
way regard antimonials, than as'^ poisons, which in va-
rious degrees, and by smaller doses, poison partially, or
in other terms subdue,* the living powers.

Antimonials moderate the vital actions of the'^heart
and arteries, as conspicuously as they sicken thfe sto-
mach, or enervate the limbs. By subduing vascular
action universally, they are the most precibus * felai-
fuges ; by subduing the intense action of the arteries of
the brain, they clear the head in fever, and moderate

antimony.

61

the paroxysms of febrile delirium, or of madness ; by
subduing that febrile action of the vessels of the skin,
which prevents secretion, and thickens and inflames it,
they take off the dry hardness, and burning heat, and
restore it to its moist and natural condition, and bring
on penspiration ; and when perspiration is completely
restored, by the sedative power of antimony, and the
vascularity of the skin slightly excited to action by the
cordial power of opium in small doses, the fever is con-
quered. It is not by procuring perspiration, far less by
^scharging morbid humours through pores of the skin,
that antimony allays fever ; it is febrifuge in itself, and
by its simple operation as a sedative ; for febrifuge doses
of antimony are small and frequent, doses which operate
insensibly as sedative,, while the attendants are looking
for some visible effect. c

Antimony, then, is rarely given, as Ipecacuanha is,
merely as an emetic ; for ipecacuanha is local in its opera-
tion, it merely stimulates the stomach ; antimony is uni-
versal, as it affects the whole system : ipecacuanha is re-
served almost exclusively for disorders of the stomach
or bowels ; antimony is used quite otherwise, viz.

First, As a sedative, affecting the whole nervous,
system, in mania, deliriuji.

Second, As a febrieuge, or in other terms, a Seda^
tive, fit to subdue excited vascular action, in synocha,
or simple inflammatory fever, unaccotnpanied with symp-
toms ; in CYNANCnE^TONSIBLARIS, SCAREATINA, VA-
RIOLA, MORBiLLi, ERYSIPELAS, &c, viz. Inflamma-
( tory Fever, with local inflammation of the Glands,
Skin, &c. , ,

Third, In pertussis, peripneumonia, hepatitis,
&c. via. Inflammatory Fever, accompanied with inflam-
mation of the internal parts. i

In all this class of diseases, where high vascular ac-

63

ABUSE OF -ANTOIONY IN FEVER.

tion comes on suddenly, in a youthful patient, in perfect
healtli, it is upon the sedative power of the medicine,
that we are to rely ; But evacuations of every kind are
at the same time desirable, antimony is therefore given
in full and quickly repeated doses, so as to occasion
vomiting first, then purging, and finally to bring on a
profuse perspiration. , >trru9'.

Fourth, Antimony is also used in low fever,
whether arising from the mortal power of infection^
as Typhus, and the Plague ; or from direct poison,
as from a wounded finger in dissection; or* from
marsh miasmata, i as in the remitting and continued
fevers of wann climates. But in all these, f Anti-
mony is to be used with other intentions, and ne-
ver without the utmost precaution. That the eva-
cuation of the bowels by purges, and that the conti-
nued use of calomel, is useful in such fever, ia no argu-
ment in behalf of the subduing sedative power of An-
timony. Often when Antimony has been given rashly
in such fevers, where wine rather, and opium was re-
quired, I have seen a patient direcUy sicken, sink into
a low muttering delirium, and die. When, in such low
fever, there is a quick jerking pulse, a flushed face, and
vascular action in the head, very moderate doses of An-
timony, (never sickening doses), may be given, to sub-
due the pulse, and soften the skin ; but with these
opium must be conjoined, and wine.

Fifth, Antimony is given as a cure for that irritated
condition of the vascular action of the surface, which
occasions eruptions and cutaneous sores. •

Sixth, In Mania, and in Brain Fever, we give , the
Tartrate of Antimony in large doses of ten or fifteen grains,
or even a scruple; 5udi doses hardly sickening the patient,
whom they would almost have poisoned while in health.
— In Synocha, or piu*e inflammatory fever, the Anti-

PREPAUATIONS OP ANTIMONY.

63

mony tn the form of James’s Powder, viz. the Pulvis
Antimonialis, is given every three hours, in combina-
tion with Nitre, and Carbonas Calcis. — ^In S^mochus,
or fever verging towards Typhus, with much delirium,
we combine the Tartrate of Antimony with Camphor.
—In Typhus, or Infectious Fever, the little Antimony
we venture to give, is combined with Opium, — In Cu-
taneous Diseases, it is combined with Mercury or with
Narcotics. acii jju*

From the nide state of science in the last age, an age
in which calcining, vitrifying, washing, and distilling
again and again without intention, and registering the
ill-understood products under the most incongruous
and whimsical names, (was called Chemistry, we have
had entailed upon us preparations, if they may be so
called, of Antimony, which Proust or Thenard wpuld
thipk it' a merit to be able to analyse and define. The
Crocuses, SuljJmrs, and Glasses of Antimony ; the Pre-
cipitates,-Kermes, &ic. are thrown back again into the
crucible of the alchemist, and for these are substituted,
four simple and intelligible forms of the medicine, two
only of which are useful.

Fh‘st, SoLPHURETUM ANTiMONii. — The Sulphuret
of Antimony is so named, in contradistinction to its
mineralized state, in which it is natm'ally combined
with a large proportion of sulphur, while in this prepa-
ration, a very small proportion of sulphur is left. Sul-
phuret of Antimony- may be described, as a condition
of the metal almost pure, in which the metal is, by
roasting and burning, purified from arsenic, from lead,
and almast entirely from sulphur. But this-preparation is
insecure in its operation ; for, as it becomes active only
in proportion to the acidity it may accidentally meet
,with in the stomach and bowels, the same dose which

THE PREPARATION'S OF ANTIMONY.

6 1

at one time, for want of natural acidity, proves quite
inert, will at another torture like poison.

Second, Oxydum anti:jionii vitrificatum, is form-
ed by continuing the same process, of roasting and stir-
ring the mineral, till the sulphur is altogether evapo-
rated, the metal oxidated, and the white fumes cease
to rise from it. The almost pure oxide being then
urged with intense lieat in a crucible, runs into a trans- ‘
parent bluish glass, which, being reduced to a fine
powder by levigation, may be given in very small doses ;
but it is found too rough and dangerous a medicine for
use, and is indeed such as we have no temptation to
use. For,

Third, The pulvis antimonialis of the Edinburgh
and London Pharmacopoeias, is a safer and more ma-
nageable preparation. It is the result of burning the
sulphurate of antimony with hartshorn shavings ; it is
an oxide of antimony, combined with phosphate of
lime. The process is suggested by Dr Pierson as a true
imitation of the celebrated James’s Powder, and con-
tains, according to his analysis, forty-three parts of phos-
phate of lime, with fifty-seven grains of antimonial
oxide : It is inferior in strength to Dr James’s Powder,
six grains of James’s Powder being equivalent to eight
of our Antimonial Powder. This is the form of the
medicine most familiarly used as a febrifuge, in doses of
five or six grains, repeated every four or five hours.

Fourth, Tartras antimonii. Tartrate of Antimony,
or rather tartrate of antimony and potass, is the
Tartar Emetic of the old nomenclature. It is the com-
bination of the metal witiv the tartaric acid, of which
the metal is susceptible only when oxidated ; it is there-
fore formed by boiling the Glass, Crocus, or other oxide
of antimony, in a solution of supertartrite of potass,
part of which continues mixed with the crystals, but

TAETRAS ANTIMONII.

65

which can be regarded in no other sense than as diluting
the antimonial salt ; the tartrate of antimony is invariable
in its power, is no way affected by the acidity of the sto-
mach, is easily dissolved in water or in wine, and in one or
other of those forms is usually administered in solution,
— From one to three grains of tartrate of antimony
prove emetic, sudorific, and antifebrile. The watery
solution, in the proportion of one grain to the ounce of
water, given every ten minutes in half ounce doses, ex-
cites vomiting and perspiration ; and, followed by an
opiate, often puts a period to Ephemeris, or to conti-
nued fever. The solution of tartrate of antimony in
wine, under the title of Vinum Tartratis Antimonii,
holds twenty-four grains of tartrite of antimony dissolv-
ed in the pound of wine. An ounce of it is given for
an emetic dose ; and ^ a diaphoretic, from one to two
or four drachms, in some opiate, or carminative draught.
It must be remembered, that the tartrate of antimony
is affected even by vegetable infusions, is decomposed
by time, and wDl not keep.

—-Sulphas Zinci, the Sulphate of Zinc,

White Vitriol, is more used for various other purposes
than as an emetic ; but wherever, on suspicion of poison
having been swallowed, or from any other cause, we
w'ould have the stomach quickly emptied, we give a
scruple of sulphas zinci dissolved in water.

OF PURGATIVES.

Next to those sedative and narcotic medicines, by
which we regulate the sensibilities and internal action
of the animal machine, before them perhaps as a
means of curing disease, we should arrange this most
important class, by which we regulate the motions of
VOL. III. E

66

TABLE OF CATHARTICS.

the bowels, and the secretions from their surfaces and
glands. The right choice and use of purgative medi-
cines, requires both science and experience. I would
not be curious or pedantic in any arrangement of this
or of any class of medicines; yet a few obvious and
practical distinctions should be marked out, with the
view of arranging the individuals of this class, before
we proceed to enumerate their peculiar qualities and
uses.

Reflecting on the various uses of purgatives, we recol-
lect in general, that our purpose is either, 1st, to empty
the bowels, and at the same time allay excessive vascular
action, such as accompanies inflammatory disease ; or,
2d, to procure a profuse secretion from the surface of
the bowels, and a continued evacuation ; or, 3d, to
force such obstructions of the bowels as threaten life ;
or, 4ith, to support, by a gentle excitement, a regular
course of the aliment through the bowels, and a gentle
increase of the secretion, so as to enliven the actions of
the alimentary canal, and lighten those of the vascular
and absorbent systems.

1st.

SuPERTARTRAS POTASS.®, Cream of Tartar ;

Tartras POTASS®: ET SODAS,... .Rochelle Salt;

Tartras POTASS®, Soluble Tartar ;

Phosphas sod®, Phosphate of Soda ;

Sulphas sod® .....Glauber’s Salt ;

Sulphas potass® Vitriolated Tartar ;

Sulphas MAGNEsi®, ......Epsom Salt, or Bittea

Purging Salt ;

Are the choicest of the saline or sedative purges, which,
though we use them on all occasions where purging i.*!

I

TABLE OF cathartics. 67

l*equired, are more appropriate to febrile, inflammatory,
and eruptive disease. '■

2(/.

SuBMURlAS HYDRARGYRi, .Calomel ;

Convolvulus jalapa radix,... Jalap;

Aloe socotorina succus....... Aloes ;

CASsiiE SENN^ FOLIA, Senna Leaves ;

Rha:i palmati RADiXj...... Rhubarb ;

Oleum ricini,. * ^...iCastor Oil;

Are the more irritating purges, chiefly resinouSj by
which we purge quickly, excite a profuse secretion, and
procure watery stools in consequence of such increased
secretion from the surfaces of the intestines.

3c?;

StAlagmitis CAMhoGioiDES,......Gum Gamboge;

.CucuMis COLOCYNTHIS, Bitter- Apple ;

Convolvulus scAMMONiA,...;;...;Scammony ;

Momordica elaterium, Wild Cucumber;

Helleborus NIGER, Hellebore ;

Are the more violent drastic, or hydragogue purges ; those
by which we excite profuse secretion and absorption; those,
.by an admixture of which, we quicken the effect of other
less powerful purges ; and they are especially those, by
which we expect to overcome obstruction from extreme
torpor, and by which, though that is not at all timfes
prudent, we endeavour to force any naechanical and
fixed obstacle to the course of the aliment. •

68

TABLE OF LAXATIVES.

Mh.

Cassia fistularis, the Pods of Cassia ;

Fraxinus ornus succus, Manna;

Magnesia ;

Seminum ricini communis oleum, .Castor Oil ;

Sulphur ;

Super-sulphas potass^e, PoUychrest Salt ;

Are the milder and more gentle purges, called Eccopro-
tic or Laxative, which we use in a familiar way, for
maintaining the regular course of the aliment, and sup- i
porting the secretion from the internal surface of the I
intestines. ’

The natural and healthful state of the bowels, is that
due degree of irritability, that uninterrupted but un-
ceasing action, by which, without our consciousness,
the remains of our food are separated and discharg-
ed daily. When the bowels are irritated, our whole
frame is disordered, just as the rising of the pulse pro-
duces indisposition in the whole system. We see' the
food of one day discharged on the following morning ;
we know that the natural revolution of the intestines is '
once in twenty-four hours ; we find spinage, turnip,
bark, or any other laxative food or medicine, returned
in twelve hours ; we find a laxative aloetic pill operating
in twelve hours; a purging potion or pill, senna, or com-
pound powder of jalap, operating in two hours ; but J
often indigestible or offensive things are hurried through I
the whole tract of intestines in an hour. I have seen |f
those to whom Peruvian bark was offensive, and whose
bowels were empty when a large dose was given, pass _
the bark with a rapid but not painful action of thel|
bowels, in less than an hoim

OP THE MOTIONS OP THE INTESTINES. 69

The condition of the bowels, both in respect to in-ita’-
bility and capacity, varies in every period of life. In
children, the intestines are short and irritable ; thence
Diarrhoea is the natural indisposition of children, and
perhaps the most fatal disease of infancy, — In youth,,
the intestines are still irritable, diarrhoea a frequent dis-
order, and Ileus, Intus-susceptio, and other dangerous
forms of inflammation and obstruction, are frequent. —
In those somewhat advanced in life, from luxiuy and in-
dulgence in men, in women from frequent pregnancy,
the alimentary canal is elongated, the diameter and ca-
pacity of the intestines increased, the mesentery and
the colon loaded with fat, and languor prevails in the
actions of the bowels : In this period of life, and

from those causes, intumescence of the abdomen, indi-
gestion, flatulence, and colic, are the prevailing dis-
eases.

This change in the condition of the bowels is one
cause of the decline of the whole system. A tumid
abdomen, whether in a child or in an adult, is an unfa-
vourable sign of health, or a mark of declining years.
The abdominal congestion of rachitic children, indicates*
a degree of that slight paralysis which arises from com-
pression of the spinal marrow. The flatulent abdomen,
and constitutional constipation, of those advanced in
life, is a consequence of the lessened irritability of the
nervous system, as distinctly as imperfect vision is from
obtuseness in the optic neiwe : The bowels are always
paralysed in hasmiplegia and palsy, and are not to be
moved by the most irritating purges, or the sharpest
glysters, such as we prescribe when a man, being struck
with apoplexy, lies in a state of torpor.

Always when the bowels are torpid, the stomach is
flatulent, the colon distended, and the appetite and
health ruined; and the progress of this change it is

'70 EFFECTS OF CONSTIPATION.

very interesting to observe. When the fasces first
pass down from the small into the great intestine,
they are thin and yellow; but being detained some
time in the great intestine, the morning-stool is firm
and dark-coloured : if a second stool foUow, it is yel-
low and thin, and has the form of diarrhoea : if the
morning-stool be postponed, the same faeces passed
in the evening are black, hard, and faetid : if stiU longer
delayed, viz. to a second day, the stomach is flatulent,
the bowels distended, there is a threatening of diaiThoea,
and the appetite is gone. If, instead of habitual costive-,
ness from languor, the bowels are mechanically obstruct-
ed, from stricture of the rectum for example, the grosser
faeces being prevented from passing, and only the thin-:
ner permitted to flow, flatulence is still the most con-
spicuous part of the disorder, with a languid appetite,
a sallow visage, and declining health : These are the in-
separable signs of simple constriction of the rectum ;
for though there is i neither pain, ulceration, nor any
kind of suffering, the patient is exhausted, and dies.

It is to be recollected, that faeces consist not merely
of digested food, bile, and pancreatic and gastric juices,
but of a profuse secretion from all the internal surface
of the intestines. The abdomen of a new-born infant
is very tumid, its intestines greatly distended, and this
although the child has never swallowed food ; and there
is, for several days after birth, while yet it has neither
swallowed food nor milk, a profuse evacuation of what
is named Masconium. In those who liave suffered ab-
scess and bursting of the intestine, though the fasces pass-
ing along the upper parts of the canal are all poured out
from the fistula at the groin, the patient has, notwith-
standing, large stools, and somewhat solid, generated
merely by the secretions from the inner surface of the

OF THE SECRETIONS OP THE INTESTINES. 71'

intestines ; and such stools pass once a fortnight, or once
a month, according to circumstances.

This secretion is essential to the natural condition of the
intestines : It may be excited : The operation of purges
is not merely that of irritating their muscular fibres, so as
to hurry along indigested food and fa2ces thinner a little
only in consequence of being speedily discharged; but that
of exciting, at the same time, a profuse secretion from the
glands,and a s^us exudation from exhalentvessels on the'
surface of the intestines, so as to produce a succession of
thin and watery stools, not diluted by drink, and yet much
exceeding the quantity of fluids swallowed. Thence it
must be inferred, that purges are medicinal, not merely
by emptying the intestinal canal, but by exciting an
increased secretion : Frequent purging and spare

living rather strengthen than weaken the body, and
maintain health, by preserving the appetite keen, and
the absorption quick ; by saving the system from feel-
ings of oppression and languor, and the abdominal vis-
cera from over-distension and undue growth. It is thus
that mineral waters, i. e. diluted saline purges, long
continued, in circumstances favourable (viz. at water-
ing-places of public resort) to exercise, and elevation of
spirits, have such power in restoring and preserving
health.

The right use of purges, and the various forms and
combinations of purging medicines, is one of the most
important parts of our science ; but it is unfortunately
a part of the science, so founded in experience and ob-
servation, that it cannot well be taught in words. The
very form in which purges are administered, the degree
in which they are diluted, and their various combina-
tions, affect their operation.

First, Purging powders, as powders of

jalap, submiu-iate of mercury, supertartrite of- potass,'

72

VARIOUS FORMS OF PURGES

rhubarb, senna, solutions of neutral salts : Purging po-
TioNS, also, as tinctures of jalap, aloes, senna, or hellebore,
affect the upper parts of the alimentary canal, operate
quickly, and sweep along all the fceculent contents of
the duodenum, and ileum, from the stomach downwards ;
but with this disadvantage, that in sickness, and in de-
licate or irritable conditions of the stomach, such potions
and powders are hardly received before they are rejected.
These are purges used only of course in a healthy condition
of the alimentary canal ; they are used merely as purges,
and with the purpose of exciting a profuse evacuation
from the glands and exhalent vessels of the surfaces of
the bowels.

Second, Pills, though formed of the same

medicines, viz. calomel, jalap, and aloes, are not so quick-
ly diffused ; are not so apt to sicken ; continue entire
until they reach the lower parts of the alimentary canal ;
are more easily retained ; and are hence more naturally
administered in the mechanical obstructions, as incarce-
rated hernia, volvulus, and intus-susceptio : and it should
be added, that pills long kept are often so hardened, as
to pass like fruit-stones, with little effect.

Third, Clysters, which are used on the

most trivial occasions, to procure a partial evacuation
and relief, are also of the utmost importance in- colic,
ileus, and other desperate disorders ; for it is our cus-
tom, in circumstances of danger, to operate from above
dowmvards, using aU these forms of medicine succes-
sively ; prescribing purging pills in the morning, as ca-
lomel, with aloes or scammony ; a purging di-aught of
tincture of jalap, or infusion of senna, in the afternoon ;
and towards evening, a sharp stimulating glyster, re-
peating, according to exigency, the pills or the cb-aught.

There are certain circumstances, and those often the
most urgent, in which violent purges have none but th^

i

f

adapted to VAEIOUS CONSTITUTIONS.

73

worst effect. When the obstruction is mechanical, as
in Hernia, or Intus-susceptio, or in Ileus, inflamma-
tion and stricture have narrowed the diameter of the
gut, it is extremely dangerous to force the obstruction
by purges, much more by mechanical means, as mer-
cury, leaden bullets, and other clumsy inventions of
l;he old school. The thing to be dreaded, the disease
which is mortal, is inflammation ! The first steps to be
taken are, to abate the irritabihty of the canal, by sooth-
ing medicines, by emollient glysters, external fomenta-
tions, and wami baths ; to soothe the incited action by
opiates ; and while the patient is awakening from the deep
sleep procured by baths and opium, then to urge anew
the peristaltic motion of the intestines, by strong purges.

The next great object, after abating irritability and
spasm, is to dilute the purges, so as to render their ope-
ration easy and effectual : For the purge which, taken
without a due proportion of soup, broths, &c. to dilute
and diffuse it over the inner surface of the bowels, will
occasion much pain, and little purging, will, when aided
by copious diluent draughts, operate powerfully, yet
gently.

The object next in importance is, to adapt the pre-
scription to the condition of the patient. In the young,
vigorous, and healthy, when our object is only to pro-
cure loose stools, and a free secretion, we give bulky Sa-
line purges much diluted, as phosphate of soda, or sul-
phate of magnesia. — ^Where the stomach is imtable, and
there is a mechanical and dangerous obstruction of the
bowels, we give Resinous purges, as scammony, aloes,
and submurias hydrargyri in small doses, and in the
form of pills, that they may pass down without discom-
posing the stomach. — In the feeble and valetudinary, in
i those of sickly and uiitable constitutions, it is adviseable
to give what are called warm purges, L e. not salts in so-

74

ADAPTED TO VARIOUS DISEASES. ' ’

lutions, but gum-resins in form of tinctures ! Tinctures-
of aloes, rhubarb, jalap, melampodium, &c. Or if we'
prescribe powders, we order some essential-oiltobe mix-
ed with the sugar, and calomel ; or ginger, cinnamon,
cayenne pepper, or aromatic powder, to be added to the
aloes, or jalap. ■

In the bilious, or in the dropsical, when the sto-
mach is irritable and sickly, and when our purpose
is not merely to procure the usual increase of intesti-
nal secretion, but to irritate the whole abdominal sys-
tem ; to excite and support the secretion and evacuation
of bUe ; to evacuate the water of dropsy, by procuring'
profuse watery stools ; to assist the absorption and the
flow of urine, by helping the diuretics with drastic purges ;
we combine various drastic medicines, and concentrate
them in the smallest possible compass ; we give aloes and
scammony ; scammony, colocynth, and calomel ; or ela-
terium and gamboge, in small pills, following such
dose, when fortunately it passes downwards, with a cup
of purging infusion, or a glass of tincture. In obstruct-
ed menstruation, we give chiefly aloes, and that almost
invariably in form of pills, that the medicine may reach
the rectum, where it should irritate : And we support the
operation of the aloetics, by warm baths, and stimulant
tinctures.

Thus we perceive, that besides skill in the choice and
in the dose of the purging medicine, the result is
varied by the very form in which it is given : It were
as unskilful to give a large draught of cold and nauseat-
ing salts on a sickly stomach, as to give a dose of aloetic
pills to one whose stomach is oppressed with bile and
crapula, when our design was to sweep along all the
contents of over-distended and paralysed bowejs.

OF SALINE PUBGES.

75

First Class. '

SUPERTARTRAS POTASSAE, Cream of tartar, consisting
of thirty-three parts of potass, and sixty-seven of tartaric
acid, is advanced to the first rank as a pleasant purge ;
refreshing and cooling, peculiarly useful in plilegmasiae,
and in eruptive diseases. It is the most familiarly used,
not merely as a cathartic, but as a sedative and diuretic,
and is daily prescribed in conjunction with jalap, elate-
rium, and other resinous purges. — When given alone
and as a purge, it is prescribed in doses of from half an
ounce to an ounce, a drachm being given every hour
dissolved in water, sweetened with sugar, and some-
times made pleasant by the addition of a little Madeira
wine. Dissolved in whey, or mixed with honey, it is
extremely pleasant ; or given in electuary, made with
confection of oranges, viz. marmalade, and diluted with
.syrup.

Tartras POTASS^ ET SOD.®, Rochelle

salt, is far less pleasant than the supertartrate. It is a
perfect neutral salt, well crystallized, very soluble, of
a bitter taste, and not very nauseous. It is frequently
prescribed in solution, along with a small proportion of
manna, in exanthematic and inflammatory diseases ; the
dose is an ounce of the salt, with two drachms of manna,
dissolved, or mixed rather, in six or eight of boiling
water.

I Tartras potassae, the soluble tartar of

i the old pharmacopceias, differs only in the superfluous
I acid of the supertartrate being neutralized, by adding
carbonate of potass instead of carbonate of soda, so as to
; produce a homogeneous neutral salt, very apt to be par-
jtially decomposed by the addition of vinegar, lemon-
juice, or any vegetable acid. It is of a bitter unpleasant

76

SALINE PURGES.

taste. The dose is, half an ounce as a laxative, one ounce
as a purge. It is in small doses aperient, and cooling, and
often a weak solution is given, after the taking resinous
purging pills, to promote and facilitate their operation.

Sulphas potass^e, vitriolated tar-
tar of the old pharmacy. This is a neutral salt less
deliquescent than the others, and more difficultly dis-
solved : it has the same bitter taste, is more nauseous
than that just mentioned, and it is more used in doses
of one drachm as a laxative, than in larger doses as a
purge, for that requires a dose of four or five drachms.
This also, dissolved in cinnamon-water, &c. is often pre-
scribed in angina, erysipelas, scarlatina, and other inflam-
matory diseases, as a gentle and cooling purgative.

Sulphas sodas, Glauber’s salt, has an

intense, bitter, and very nauseous taste, but was not-
withstanding the favourite, and almost the only purga-
tive used in inflammatory diseases, till of late years su-
perseded by the phosphate of soda.

Phosphas sod^, is another medicine for

which the profession remain indebted to Dr Pearson. It is
prepared by a complicated process, is of higher price than
the other neutral salts, but is incomparably better, in
being very little nauseous, hardly different in taste,
when much diluted, from common salt. It is easily re-
tained, even by those of a delicate stomach ; and when
diffused in a large basin of beef-tea, or mutton-broth, or
even in water, is no way nauseous : given in the quan-
tity of eight or ten drachms, is an excellent purge.

Sulphas magnesia, or Epsom Salt, is

magnesia neutralized with sulphuric acid. Of all the
purging neutral salts, it is the last we should choose to
prescribe, being intensely bitter; were it not, that it
purges in small doses very easily, with little pain, and
is even found, as in cholicy and bilious disorders, to allay

CALOIHEL.

77

pain. Two tea-spoonfuls, i. e. three or four di’achms of
the salt, dissolved in a large tumbler of cold water, pro-
cure one or two loose stools, whOe a third more proves
an effectual and very easy purge.

Second Class.

With the resinous and powerful purges, I choose to
join Calomel, as often given in combination with them.

Stjbmurias hydrargyri. Calomel, is at

once an effectual purge, and a powerful sedative ; but its
invaluable properties as a sedative, or in combination with
narcotics, are not now in question, we speak of it only
as a purge. — Calomel takes precedence of all other purges,
wherever we wish to subdue inflammation in the bowels,
as in the case of Ileus, the small intestines being inflamed,
and the patient tossing with pain : — or when spasm is to
be resolved, and colic pains allayed, as in disorders of
the lower intestines : — ^when, in mechanical obstructions
of the bowels, as in hernia, volvulus, or knotting of the
intestines, from inflammatory adhesion, we need to con-
vey the most effectual purgative, in the most compen-
dious form: — when our intention is, to relieve acute
inflammatory disease, as in cynanche stridula of children,
or affection of the brain, as hydrocephalus, or inflamma-
tion of the viscera, as in hepatitis : — When our purpose
is, in fever, or in bilious colic, to purge the alimentary
canal of bile, this is an invaluable ingredient in any pill
or powder : it is heavy, so that many grains of calo-
mel may be conveyed in very small pills ; it is tasteless,
passes easily down, and in particular habits sits easy on
the stomach.

Calomel may be ^ven from doses of five grains, such
as we give to a child, to fifteen, or even to a scruple,
which we may prescribe for an adult. It is besjt given

JALAP.

7B

' rubbed down with a little sugar and cream of tartar, for
a child: — For an adult, and in cases of imminent danger, it
is given in larger doses, rubbed down with cream of tar-
tar, sugar, or magnesia, and a few drops of some essential
oil are mixed with the powder, to make it sit light on
the stomach : — Or it is given, to augment its sedative
power, in combination with a few grains of camphor ; or,
to prevent sickness, is mixed with aromatic powder.

When given alone in form of bolus, calomel is usual-
ly mixed with conserve of roses, and given in form of
a soft bolus, that it may not pass, as calomel pUls often
do, with little effect. But calomel, powerful though it
be, is usually reinforced by some purging draught, given
two or three hours after the bolus, at such distance of
time as not to provoke the stomach to reject it : Or it
is given in combination with resinous purges, with a
scruple of jalap, with four or five grains of gamboge,
with eight or ten grains of aloes, or scammony, in soft
and soluble piUs ; and such piUs are again followed by a
draught of senna infusion, or of tincture of jalap. — These
slight notices w^ill serve as the theory of the several
forms in which calomel is prescribed ; and it is still
to be remembered, that as we confide much in the se-
dative powers of calomel, it will be often found prescribe
ed in the most acute inflammatory diseases, along with
opiates, and the warm bath, as antidotes to inflammation
and spasm.

Convolvulus jalapa. Jalap.— The root

of a climbing plant, indigenous in Mexico ; of a nauseous
smell, and an acrid rather than bitter taste, leaving
a painful sensation in the fauces long after it is swallow-
ed.— Though unpleasant, and to some sickening, it is not
strong tasted ; and from its qualities, it is the purge most
familiai-ly used, and most relied on. Given alone, in a dose
of half a drachm, it proves a brisk pimgative; combined, as

ALOES.

79

k usually is, with supertartrate of potass, less suffices.
A drachm of the compound powder of jalap, contains two
scruples of cream of tartar, and one of jalap ; a drachm
usually purges, but two may be very safely given. — It
is often prescribed in combination with calomel, in the
form of purging piUs, which should always be made on
the occasion, for they should be soft. In order to mitigate
the irritating quality of jalap, it is triturated with sugar,
cream of tartar, or some neutral salt, by which its par-
ticles are divided so as to diffuse the medicine, and make
its operation effectual: This precaution should in-

deed be observed in regard to all the resinous purges.

Jalap is the best occasional purge ; it moves the bowels
instantly, it produces great secretion from the internal
surface of the intestines, and profuse watery stools with
but slight irritation, and it is the medicine we can longest
continue to use, in order to support a constant discharge.

Aloe socotorina, aloes of the island of

Socotra ; an inspissated resinous extractive juice, brought
from the East Indies, and from the coast of Africa, from
the West Indies, and especially from the Cape of Good
Hope. It is an intense disagreeable bitter, but not sick-
ening ; on the contrary, it is one of those bitters which,
taken daily in small doses, is thought to repaii* the
strength of the stomach. — Aloes, unlike jalap, has little
power of augmenting the intestinal secretion ; it pro-
duces no loose stools, it operates merely upon the rec-
tum ; it requires of course many hours, from ten to six-
teen, for descending to that point, which it cliiefly af-
fects.— Given at night, it operates gently in the morn-
ing : given in a small dose, it merely opens the bowels,
producing a lax stool, but no purging, and thence it is
the basis of all the popular antibUious and stomachic
pills : Given in a full dose, it powerfully irritates the
rectum, and by exciting vascular action it inflames the

80

SENNA.

part, causes haemorhoidal intumescence of the verge of
the rectum, and by sympathy affects the uterine sys-
tem ; whence it constitutes the chief medicine in all
those pills, or tinctures, which are advertised daily as ef-
ficacious in Female Complaints. It is of course a medi-
cine more suited to cold pale plilegmatic constitutions^
and those advanced in life, and subject to stomach-com-
plaints, than to the young and sanguine who are subject
to inflammations.

This medicine is too unpleasant, too intensely bitter,
too druggish in its taste, to be easily taken in powder :

It is prescribed chiefly in the form of pills, combined
with calomel, scammony, gamboge, colocynth, and other
drastic purges, with bitters and aromatics in stomach
complaints ; or finally, in the form of tincture. For all
the purposes of active practice, viz. procuring wateiy
secretion, profuse evacuations, and forcing obstructions,
as in hernia, &c. jalap is the preferable medicine. But
as a laxative, stomachic, antibilious purge, as a constant
stimulus to weak intestines, as a habitual coivector of
costiveness, aloes is the best we know of The dose
is from five to fifteen grains, given at once or at in-
tervals.

Senna, CASsiiE sennas folia, Senna

I^eaves, are annuals growing in Nubia, and Upper
Egypt, brought to Alexandria, and imported ^thence,
or from the Levant : though not intensely bitter, it yet
is bitter, nauseous, and acrid: it occasions griping, if
not joined with aromatics, and much diluted : it is a |
sharp purgative, but is used less for any particular pur- ^ i-
pose, than to scour off other medicines, and as a purge 31
for children. It is seldom given in powder, a drachnr I
of which proves purgative, unless in the form of elec-:»‘
tuary. Senna, I may almost say, is only used in forinl'
of tincture, or infusion : The infusion is best made, b^

RHUBARB.

81

pouring ten ounces of boiling water upon two drachms
or more of the leaves, allowing the infusion to remain
by the fire for an hour. A cupful, four or five ounces, of
this is given to a child or adult, after a dose of calomel,
jalap, rhubarb, and cream of tartar, &c. to quicken its
operation. To such infusion, a few coriander seeds,
a little ginger, or cassia, and often two drachms of
cream of tartar, with a little syrup, or sugar, are added
to the dose.

Rhubarb, rh.<ei palmati radix, is of

a subacrid, bitterish, and somewhat astringent taste;
nauseous, yet seldom sickening : It is a safe and gentle
purgative: a scruple or half a drachm is required to
serve as a cathartic : and as this is a bulky dose of a
bitter and unpleasant drug, it is lessened by combining
with a scruple of powdered rhubarb, six or eight grains
of calomel ; or a smaller purging-pill or bolus of rhubarb
is given, reinforced by a cup of senna infusion, with the
addition of a few grains of calomel, or an equal propor-
tion of cream of tartar. It is found to be an excellent
anthelmintic, and no medicine is more commonly used
for children, to purge off any bitter anthelmintic pow-
der, as the semen santonica ; it is a purge so mild and
gentle, that it, more than any other, combined with
I magnesia, is prescribed for children.

Rhubarb is almost in as much request as a stomachic.
A few grains taken in the morning daily before break-
fast, and repeated at mid-day ; or a little of the tincture,
which, being made with spirits, can only be taken as a
stomachic, and not in such quantity as to piuge, — are
j the usual prescriptions.

Oleum ricini. Castor Oil, is the oil ex-

i pressed from the seeds of the Palma Christi, a plant not
absolutely peculiar to Africa or the East, but cultivated
in the West Indies, and growing also in the southern

VOL. III. p

82

OF DRASTIC PURGES.

climates of Europe. The seeds swallowed entire, or a
little bruised, prove strongly purgative. The oil has a
rancid, bitterish, and somewhat acrid taste, and yet the
finest is very little offensive : given in the dose of half an
ounce, it operates as a gentle laxative ; an ounce proves
purgative. It may be given floating on a glass of cold
water, when it glides over unperceived ; or on a Cup of
coffee ; or mixed with sugar, mucilage, syrup, and dis-
tilled waters, in the form of emulsion draught. It is
so mild, gentle, and unoffending to the bowels, that
this purge alone is unexceptionable in cases of Enteritis,
and Inflammations of the stomach or bowels.

THIRD CLASS, — DRASTIC PURGES.

t

• Gamboge is the gummy, resinous juice,

exuding from incisions in the branches of a tree indige-
nous in the East Indies, especially in the kingdom of
Siam. It is of a strong opaque yellow colour, and is
used in washed drawings, as a paint. It is, when dis-
solved in water, a milky-like juice, almost insipid, of a
sweetish and slightly bitter taste, but after a little it is
found intolerably acrid in the throat and fauces : it may
be ranked among the poisons, from its extreme acrimo-
ny. Given in a large dose, it excites vomiting and
purging, with tormina in the bowels ; the best antidote
is alkali and opium. Gamboge is seldom used alone,
but chiefly with the intention of quickening the opera-
tion of less acrid purges, and as a vermifuge ; for it is
particularly destructive to worms, especially to the Ta?-
nia and Cucurbitini.

Gamboge, when given as a purge, is to be tritu-
rated with cream of tartar, and combined with calo-
mel or jalap; it is particularly esteemed as a hydra-
gogue in dropsies, the dose bemg from three to five
grains, rubbed down with ten grains of sugar, and

COLOaUINTIDA. — SCAMMONY. — ELATERIUM. 83

fifteen of cream of tartar ; or, a grain of gamboge may
be added to each purging-pill of calomel and aloes ; or,
three grains of gamboge may be nibbed down with half
a drachm of the compound powder of jalap.

CoLOQUiNTiDA, Cucumis Colocynthis, is

the medullary juice, extremely bitter and acrimonious,
of a kind of gourd growing in Turkey ; and its purga-
tive powers are so acrimonious and drastic, that by
many it is regarded as httle better than a poison. This,
given in great doses, with the design of forcing abortion,
has often proved fatal to pregnant women, the flooding
and miscarriage being attended with fatal tormina of
the bowels, bloody stools, and convulsions. It is seldom
directly used or alone, but is mixed, like gamboge, in a
small proportion in purging-piUs of other ingredients.

ScAMMONY, Convolvulus Scammonia, is

the concrete milky juice of a climbing plant, indigenous
in Syria, and brought home to us from Aleppo and
Smyrna ; its smeU is nauseous, its taste acrid and bitter.
This also is used more frequently to sharpen the quali-
ties of less active drugs : It is not, as once reported, un-
safe when given alone, and of course in a full dose.
Though it never is a gentle nor trivial, it is a harmless
and most effectual purge ; it is given after being well
triturated with sugar, in a few ounces of almond emul
sion ; or in powder, triturated with cream of tartar and
sugar. The dose, in either of these forms, is six, eight,
or ten grains ; more can hardly be given safely.

— Elaterium, Wild Cucumber. The pulp

of the cucumber is a very drastic purge, less frequently
used than any, but reputed a very powerful hydragogue,
and used accordingly in dropsies, but it is very cau-
tiously and sparingly used. It is a drug, with the vir-
tues of which I am little acquainted.

F 2

84

OF LAXATIVES.

Helleborus NIGER, Block Hellebore,

the Melampodium of the ancients, is a root of a bitter-
ish taste, and especially nauseous and acrid, in so much
as to aifect the tongue with a sort of stupor and sore-
ness. The ancients dealt largely in hellebore, especially
in diseases of the head ; and we also prescribe it chiefly
in mania, and still more properly in melancholia. In
dropsy it procures a rapid succession of watery stools ;
in amenorrhasa, I find the tincture of hellebore peculiar-
ly serviceable ; and as a stomachic, it is in many cases
a very useful medicine, as a warm and stimulant drug.

FOURTH CLASS, — LAXATIVES,

Are appropriated more to the valetudinary state,
than to the cure of disease ; few of them are used as
purges.

Cassia, the pods of a tree growing in per-
fection in the East Indies, and of a coarser kind in Ja-
maica, affords this sweet, and not unpleasant laxative
It is a black, liquorice-like juice, secreted betwixt thin^
water-like diaphragms in the cane-like pod of the cassia,!
whence it is named Cassia Fistularis. The juice, melted]
in warm water from the pod, and then evaporated to a]
thickish consistence, constitutes the basis of our Leni-
tive Electuary, as it is called, in which the gentle pur-
gative powers of the Cassia Fistularis, are sharpened by
the more drastic qualities of the Cassia Senna. Cassia
itself is too mild to serve as a purgative, unless given
in the quantity of several ounces, a bulky morsel, which
would more resemble a meal than a dose of medicine. . ^

Manna, Fraxini Omi, Succus, is anothe^

laxative seldom prescribed alone, except to very infants.
It is a clear saccharine juice, exuding from this tree in
Italy during the hot season, from which it is scraped

MANNA. — MAGNESIA.-— SULPHUK.

85

coarsely off, carrying often, with the saccharine exuda-
tion, fragments of the bark, and other impurities. An
additional quantity of the exudation is gathered from
incisions made in the bark : It is said to be counterfeit-
ed by sugar and honey, with a httle spice of scammonyi
It is rarely used but as a slight aid to other, and chiefly
to sahne purges, two drachms being added to an eight-
ounce solution of any of the neutral salts. But with
children, weak as it is, it proves purgative ; and a solu-
tion of manna is easily taken by an infant, and is with
nurses a favourite medicine for piuging off the meco-
nium, or feces accumulated in the bowels before birth,
and in the yellow gum or bile of new-born children.

Magnesia is also a medicine of too little

power to move the bowels, unless when, combining with
accidental acidity of the stomach or bowels, it forms an
earthy salt, and too weak at the best to prove more than
laxative. In adults, it serves no other use but to cor-
rect acid, as in heartburn ; but in children, where acidity
of the stomach always prevails, magnesia is never mis-
placed, and always purges. A httle magnesia and rhu-
barb, therefore, in the proportion of three parts of mag-
nesia to one of rhubarb, is the favourite medicine of
mothers and nurses.

Sulphur is an admirable laxative, though

it requires a large dose to operate as a purge. Two
drachms of sulphur, mixed with a httle honey, or, after
being mixed with honey, diffused in milk, and taken
early in the morning, is an excehent, mild, and most
efficacious laxative. Sulphur, taken frequently, taints
the whole system with its smeU conjoined with cream
of tartar, in the proportion of one part of the former to
two of the latter, it is particularly enjoined to patients
afflicted with piles, — ^a proof sufficient of its being a
gentle and yet effectual laxative.

86

PURGING PILLS.

Super-sulphas potass^, Pollychrest

Salt, is a salt, the eulogium of which was intimated in
its name ; a salt, it was named by the older chemists, of
innumerable virtues. With the less enthusiastic
moderns, it has descended to the humble condition of a
neutral salt, with a shght super-saturation of sulphuric
acid. It is more used as a laxative, an alterant, or a
species of artificial mineral water, than as a purge. The
usual dose is a drachm, or two drachms, dissolved in a
large glass of water, and taken in the morning. Though
unpleasant, and almost nauseous to the taste, it is mild
and gentle in its operation, and still with myself and
many others, almost as favourite a medicine as in those
days when it was named, par excellence^ PoUychrest
Salt.

To complete this catalogue of purging medicines, and
instruct the student in all their most useful forms, it is
necessary to enumerate now a few compounds, viz. Pills,
Infusions, Electuaries, and Powders, which owe their
virtues to judicious combinations of those simple drugs.
This is a necessary supplement.

OF PURGING PILLS.

PiLULiE ALGETIC.® are formed of aloes

beaten up into a mass with soft soap ; and sometimes,
as in the receipt of the Dubhn College, with an equal
proportion of gentian, and a few drachms of ginger to
the ounce of the mass. Those medicines warm the sto-
mach, and make the aloetic piU a fitter laxative for cold
and aged constitutions, affected with hypochondriacal com-
plaints, or with dyspepsia. These pills, given two' at nighty

aloes and COLOCYNTH. — CALOMEL AND JALAP. 87

and three in the morning, prove sufficiently laxative ;
sometimes the two of the evening suffice. In a larger
dose, aloetic pills are useful in amenorrhaea.

To give aloetic pills effect as purgative,' we jnix with
three parts of this mass, one part of gamboge, and di-
vide the whole into pills, — the pilul-® aloes, et sta-
LAGMITIDIS GAMBOGIOIDES, — a very useful, but some-
times a sickening dose.

PiluljE aloes cum colocynthide, are

powerful piu'ging pills, little beholden to the aloes for
their virtues, being compounded chiefly of much more
active drugs, viz. Scammony and Colocynth, which are
the chief ingredients : The proportions are equal parts
of Socotorine aloes and scammony, with half a part of
colocynth, and a small proportion of sulphate of potass,
with which the aloes and scammony are diligently tritu-
rated before they are formed into a mass ; and this is
done with a small proportion of oil of cloves, and with
mucilage of gum-arabic. The mass being divided into
five-grain pills, two serve as an effectual laxative, six as
a smart purge, containing ten grains of aloes, ten of
scammony, and five of colocynth.

— ^ ^PiLUL.® RH^i coMPOSiTJE, the Com-

pound Rhubarb PiU, is not expected to operate as a
purge ; it is scarcely laxative ; it is chiefly useful as a
stomachic. The mass is composed of rhubarb and aloes,
in nearly equal parts, with a third part of myrrh, and a
small proportion of oil of peppermint. Compound
rhubarb pills warm the stomach, improve digestion, pre-
vent flatulence or pain, and gently move the bowels.

Purging pills, such as are formed of

Calomel and Jalap, cannot well be preserved moist ; and
even aloetic pills we are at pains to preserve from a de-
gree of hardness which would make them ineffectual,
by forming the mass with soap : but purging compound

88 POWDERS OF JALAP, SCAMMONY, &C.

powders are easily preserved, and many-- of those are
kept in the shop.

OF PURGING POWDERS.

PuLVis JALAP.® roMPOSiTUS, is the

Powder of Jalap, mixed with two-thirds of the super-
tartrate of potass ; the trituration of the jalap with the
cream of tartar, grinds and divides the resinous par-
ticles, and makes the operation gentle. We use this
powder with children, as with adults, more familiarly
than any other purge ; from two scruples to a drachm,
or a drachm and a 'half, constitute a purgative dose,
mild and gentle in its operation.

A similar purging powder is often used, of rhubarb
and cream of tartar, in the same proportions ; but a
drachm of it is required as a laxative, and more than a
drachm and a half for a purge.

Ai.oes in POWDER is mixed with Canella

Alba, in the proportion of one part of the spice to
eight parts of the aloes ; from twelve to fifteen gi-ains
of the powder suffice for a dose. It is mixed, too, with
Guaiac, (the Pulvis Aloeticus cum Guaiaco). It is mix-
ed with any thing that may have a chance of subduing
the harshness and intense bitter of the medicine : Still

it savours of horse-drugs, and is rarely prescribed. A-
loes is mixed with gentian, myrrh, and sulphate of iron,
in the Pulvis Aloeticus cum Ferro, which, though a
precious combination of aromatic and stomachic bitters
with iron, and though truly a useful emmenagogue, is
yet a medicine better adapted to the hospital than to^
private practice.

All the more powerful resinous purges are often com-
bined in one powder, — -jalap, scammony, and aloes.

—^—Pulvis scammoni® composites, is scam-

CALOMEL AND SCAMMONY. 89

mony and extract of jalap in equal proportions, with a
fourth of powdered ginger ; and in some Pharmaco-
poeias, a small proportion of neutral salt is interpose,
with which the resin is triturated, and divided. Ten
or twelve grains of this powder, taken in a tea-spoonful
of marmalade or jelly, operates as a drastic purge.

— — — PuLvis scammonia: cum Aloes, is a pow-
der of equal or nearly equal parts of aloes, jalap, and
scammony, with a small proportion of ginger, to excite
and warm the stomach, and save the patient from sick-
ness : Eight or ten grains of this powder operate as a
purge ; but if ineffectual, lesser additional doses may
be continued from hour to hour.

Scammony is often triturated with submurias hydrar-
gyri and sugar, forming the pul vis scammonia: cum
SUBMURIATE HYDRARGYRi, in the proportion of two
grains of calomel to four of scammony ; it is a simple
and most effectual formula, such as may be given in
doses of eight or ten grains with particular propriety,
when in dropsy of the abdomen, our purpose is to ex-
cite the circulation of the abdominal viscera, and by
irritating, to procure a rapid succession of thin stools,
and to assist diuretics, as the Digitalis.

Scammony is also prescribed in combination with
senna, and both mixed and triturated with supertartrate
of potass. This makes a valuable purging powder, too
little used ; the proportions are two parts of cream of
tartar, two of powdered senna leaves, and one of scam-
mony, with a little ginger. This is the pulvis senn.®

COMPOSITUS.

. OF PURGING INFUSIONS.

Senna is the medicine most commonly

used as a purgative infusion ; Senna leaves macerated

90

• INFUSION OP RHUBAKB.

for an hour in boiling water, the jug or tea-pot placed
by the side of the fire, yield their purgative quality ;
and senna thus infused with a small proportion of ginger,
or Muth a few drachms of cream of tartar, or with ta-
marinds and coriander seeds, makes indeed an ele-
gant infusion. A small tea-cupful of any of these
proves a sufficient dose, is very little offensive, nay, al-
most pleasant to the taste, and light on the stomach.

■ ^Rhubarb. A strong infusion of rhubarb,

in the proportion of twelve drachms of grossly-powdered
rhubarb to six ounces of boiling water, with the addi-
tion, in order to preserve it, of half an ounce or an ounce
of alcohol, or of spirituous cinnamon water, is an excel-
lent purgative. This is indeed the best preparation of
rhubarb, — half an ounce of such infusion, which is at
the same time a stomachic medicine, proving a very ef-
fectual purgative.

OF PURGATIVE TINCTURES.

• Tinctures are neither the most pleasing, nor the most
efficacious forms of medicine. There are few disorders
in which we should chuse to give our patient an ounce
or two of spirits, whether raw or medicated, at a draught.
Tinctm-es, thence, are never used in inflammatory dis-
ease, an exclusion which takes away more than half
their value. Tinctures aie useful only when we would
not regret the stimulant effect of the alcohol, as in sto-
mach complaints, in dyspeptic and hypochondriacal
disorders, in amenorrhaea, and in long-continued com-
plaints of the bowels, as in chronic diarrhoea, and dy-
sentery : but rarely or never can they be useful in ileus,
volvulus, hernia, or any desperate or sudden disease:
and there are very few indeed of the tinctures, hardly

J

' TINCTURES OF JALAP, SENNA, &C. 91

any except those of jalap and of hellebore, which can
be prescribed as purges.

Tinctura convolvulus jalap.®, is a

purging tincture, almost tasteless, no way offensive,
gentle, yet effectual in its operation, and equally safe
for a child in the dose of two or three drachms, as for
an adult in the dose of one ounce, or an ounce and a
half. It is exceedingly useful in practice, since it may
be prescribed as a cathartic, mixed with any distilled
water, and with syrup. The addition of a small pro-
portion of tliis tincture, with any camphorated saline cor-
dial, or opiate julep, preserves the bowels open, without
affecting the virtues of the principal medicine, or even
its taste.

Akin to this tincture of jalap, is the compound tinc-
ture OF SENNA. When the purgative virtue of senna is
to be sharpened by that of the jalap, the proportion of
the medicines is, two parts of senna to one of jalap, with
a small proportion of coriander-seeds, as in the infusion
of senna digested with alcohol. The tincture of senna
i^ useful, like that of jalap, either alone as a purge, or as
a qualifying ingredient in any stomachic or cordial ja-
lap ; and like it, the full dose is from one to two ounces :
it was named for excellence, elixir salutis.

Tincture of senna alone, and unaided by

the jalap, is still useful, and when jalap is known to
sicken the patient, will be preferred. The senna being
tasteless, the addition of carraway and cardamom seeds,
and of stoned raisins, makes a tincture very cordial, and
not unpleasant, which may be given in doses of one or
of two ounces. These purging tinctures are particularly
precious, not as purges, but as laxatives in dyspepsia,
and chronic complaints of the bowels, especially when
mixed in prescription with aromatic and bitter tinctures.

92

TINCTURES OF ALOES AND RHUBARB.

■ .- — -Aloes, rhubarb, and hellebore, are ca-
thartics of a very different quality from these ; and while
jalap and senna are useful as evacuants, and in inflamma-
tory diseases, these bitter and astringent purgatives are
more properly laxative stomachics, and tincture is per-
haps the most favourable and efficacious form, in which
such medicines can be given ; unless when they are used
merely as laxatives or as emmenagogues, when they
should certainly be given in form of pHls. The simple
tincture of aloes has all the combination that can render
the medicine warm, cordial, and, so far as its taste will
allow, pleasing to the stomach. The tinctura aloes, is
merely the powdered aloes digested in spirits, along with
a large proportion of Spanish juice, or extract of liquo-
rice, to assist in suspending the drug, and to give it a
less unpleasant taste. Of this tincture an ounce serves
for a dose, or when used as a stomachic, two or three
tea-spoonfuls, in a glass of water, morning and mid-day.

Tinctura aloes cum myrrha, is a com-
pound tincture, formed by pouring tincture of myrrh
upon grossly pounded aloes and saffron, so as to impreg-
nate it in the proportion of one part of aloes to eight of
the tincture. *This is a strong tincture ; half an ounce of
this is equivalent to an ounce of the simple tincture : It
is the ELIXIR proprietatis of Paracelsus, and is, by the
combination with myrrh, better adapted to the purposes
of a bitter stomachic, and gently laxative tincture.

Tinctura rh^i palmati ; of this tinc-
ture there are four modifications ; Firsts Simple tinc-
ture OF RHUBARB, an infusion of rhubarb in diluted
alcohol, rendered more cordial and warm by the addi-
tion of cardamom seeds and saffron.

Second^ Tincture of rhubarb with aloes, the
ELIXIR sacrum of the older pharmacopoeias ; a tincture

tinctures in wine. 93

in which the rhubarb and aloes, with the addition of car-
damom seeds, are used in nearly equal proportions.

Third, Compound tincture of rhubarb, an infu-
sion in proof-spirits, warmed and made more acceptable
to both palate and stomach, by a small proportion of
ginger and sliced liquorice-root.

Fourth, Tincture op rhubarb with gentian,
the TiNCTURA RHASi AMARA, 311 infusion in diluted
alcohol, of four parts of rhubarb and one of gentian,—
These tinctures are selected according to the occasion ; as
alaxative,the simple tincture will be preferred; as a purge,
the tincture of rhubarb with aloes ; but the bitter tinc-
ture, the tincture amara, and the compound tincture,
viz. with ginger, are precious chiefly as stomachic me-
dicines, or for restoring the tone of the bowels, in pro-
tracted diarrhoea or dysentery; and of each of those
tinctures, less than half an ounce, given daily, serves as
a stomachic ; an ounce, or an ounce and a half, are re-
quired as a purge. '

To those warm and tonic purges, we add one more,
in my opinion, of no slight efficacy, the tinctura me-
LAMPODii vel HELLEBORi NiGRi, tincture of black hel-
lebore, which is slightly cathartic, very powerfully sti-
mulant, and an excellent addition to any of those tinc-
tures, especially when they are prescribed with the de-
sign of promoting menstruation.

The same tinctures made with wine, or in other terms,
with a lesser portion of diluted spirit, differ little from
those except in strength. The vinum aloetiqUm, or
tinctura sacra, as it is named, is an infusion of aloes in
wine. The vinum rh.®i palmati, or rhubarb wine, is
an infusion of rhubarb seasoned with caneUa alba, in
Spanish wine. These are useful, seeing that they may
be given when the spirituous tinctures would be less

94

ELECTUARIES:

proper ; but to have even a slight effect, more than one
ounce, usually two ounces, are required.

PURGING ELECTUARIES.

Electuaries are to many a more acceptable fom of me-
dicine, than pills or powders ; they are what may, with
less impropriety than any other, be termed elegant pre-
parations, if so foolish a term is to be retained^ in such
a strong-scented profession as that of pharmacy. We
had best perhaps leave such pretensions to the confec-
tioner.

■ Electuarium cassi.® fistularis, is the

pulp of cassia, mixed up with a fifth of tamai inds and of
manna, diluted to the consistence of an electuary with
syrup of roses. A few te£uspoonfuls, half an ounce of
this electuary, proves gently laxative ; and the addition
of a few grains of jalap, gamboge, or scammony, of com-
pound powder of jalap, or of supertartrite of potass,
makes it an effectual purge, of which it may be then
said to be the vehicle.

Electuarium cassi.® senn.®, is a much

more complicated, strong tasted, and druggish electuary.
It is the lenitive electuary of the shops ; it contains, be-
sides the senna which is the active medicine, a variety
of luscious sweet pulps, as pulp of tamarinds, prunes,
figs, and cassia, sugar, liquorice, and coriander seeds.
Clumsy, and coarse, and druggish, as the prescription is,
we could better spare a more elegant one, for it is ex-
tremely useful, and to many not unpleasant. One or
two tea-spoonfuls taken over night, or in the morning,
proves gently laxative ; and when we choose to sharpen
the dose, by adding to it a scruple or two scruples of
compound powder of jalap, or a drachm or two of cream
of tartar, it forms a sure and not unpleasant purge.

OP CLYSTERS.

95

We have one more cathartic electuary, and it is a
smart and powerful purgative, while these are in them-
selves merely laxative, Eccoprotic, as they are termed ; —
the Electuary of Scammony, electuarium scammonii.

Scammony, to sit on the stomach, or to be pleasant,

requires to be supported by a strong compound of spices,
and this electuary of scammony is expressly such : It is a
composition of cloves, ginger, and oil of carraway, with the
addition sometimes of s)rrup of roses ; and this compound
of spices being made, to one ounce of it is added an ounce
and a half of scammony ; a drachm and a half of the
electuary conveys fifteen grains of scammony, the half
of which dose will usually prove purgative.

CLYSTERS AND SUPPOSITORIES,

Are an important part of the apparatus by which we
excite and empty the bowels ; and besides their use in
the more dangerous diseases of ileus and colic, they are
peculiarly important in the cure of worms. The injec-
tion, I first think it right to notice, is one pertaining
more properly to the class of sedatives, calculated
rather to appease vascular action than to move the
bowels ; it is the acetous clyster, clyster aceta-
Tus. This Clyster is compounded of the common de-
coction, Decoctum Commune, as it is termed, the de-
coction of chamomile flowers mixed with vinegar, in the
proportion of three ounces of vinegar to half a pound of
the decoction. A glyster thus compounded, or of honey,
or sugar and water, with fresh vinegar, injected cold
into the rectum, is of immediate effect. In ileus ; for it
at once reduces the inflammation and irritation of the
bowels, and soon procures a stool : In the apoplectic
paroxysm, such as is frequent in scenes of feasting, tu-
mult, and debaucher)'^, or ia scenes of contention, and

96

CLYSTERS OF ALOES.

in crowded assemblies : .In the paroxysms of phrenitis
also, and of mania ; in hydrocephalus, and in an especial
manner in those who have been suffocated by charcoal
fumes, in pits or mines, and in those who are found in
a state of apoplexy from intoxication ; such a glyster
should be given without delay, and repeated ; it is ofteh
a means of saving life, by abating arterial action, and
excitinsT the bowels.

But the glyster most familiarly used, the clyster
COMMUNIS, is merely designed to excite very slightly, and
wash out the rectum. It is a solution of the muriate of
soda, or sea salt, or of sulphate of soda, of common
soda, or of common soap, dissolved in any fluid ; half |
an ounce of the salt, or of the soap, being dissolved in
less than a pound of fluid. The fluids most used are,
gruel, decoction of chamomile or of althea, linseed-
tea, or water,’ to which is usually added, two table-
spoonfuls, an ounce, of oil. This is the injection
commonly used in those who are merely costive, who
are bed-rid, valetudinary, feeble, and who use it
merely as a laxative ; and it is given to promote the
operation, when too long delayed, of any cathartic.

But when we are anxious, by exciting the rectum
strongly, to co-operate with a drastic purge, given with
the hopes of forcing any obstruction, as in volvulus, or
•hernia, we resort to strong infusions of the drastic
purges, as senna, aloes, colocynth, turpentine, &c. The
CATHARTIC GLYSTER is six ounces of infusion of senna, |
strengthened by dissohnng in it an ounce of sulphate of
magnesia, or of soda. The aloetic clyster is com-
pounded, by dissolving a drachm of socotorine aloes in
yolk of egg, mixing it with a pint (a pound) of milk,
broth, gruel, or common decoction.

Glyster of coloquintida, is simply a

solution of one drachm of extract of colocynth, in less

turpentine and tobacco clysters. 97

than a pint of tepid water ; a glyster, which excites the
bowels though in the torpor of palsy, and thence is
often preferred as a stimulant, during the apoplectic
pai-oxysm, or in those who, having the spine fractured,
are paralytic of the lower extremities, and of course in
the bladder and rectum.

Turpentine clyster is one very fami-
liarly used, and very effectual for exciting the rectum
in torpor of the bowels, and in palsy. It is best com-
pounded by beating up half an ounce of turpentine
with the yolk of an egg, adding an ounce of oil, and dif-
fusing it then in a smaU basin, less than a pint, of gruel.

The most irritating of all our glysters, and the most
to be depended upon, both as an anodyne and narcotic,
appeasing spasm in the affected part of the bowels, and
irritating aU below the constricted part, is the tobacco
glyster, which is formed by infusing less than two
drachms (more is dangerous) of cut tobacco, in ten
or twelve omices of boiling water, which in a quarter of
an hour is sufficiently strong, and which is found a bet-
ter and safer antispasmodic than tobacco smoke, which
is too irregular in its operation, and has thence fallen
into disuse.

One form more of laxative medicine remains to be
slightly noticed, viz. those cathartic syrups which are
given to children, but which are too little efficacious to
operate with the adult ; Any syrup, even a little sugar
I and water, given in spoonfuls to a new-born infant,
proves cathartic ; and a solution of borax, or of sea-salt
in water, given in the same way, vomits and purges as
effectually as tartrite of antimony in an adult.

Syrup of manna, is formed by boiling

a pound of sugar and a pound of manna, in an English
; pint of water, with the addition of half an ounce of
senna : Three or four tea-spoonfuls of this syrup suffice for

VOL. III. Cr

I

I

ANTHELMINTICS.

. I

an infant : the same dose suffices of the syrupus rhamni
cathartici, the syrup of buck-thorn, a syrup which is
prepared, by boiling up the juice of the ripe buck-thorn
berries with sugar, sometimes, as in the London receipt,
with the addition of a small proportion of pimento and
ginger, to oppose the acrimony of the medicine ; this be-
ing much less mild than the syrup of manna, and apt
to occasion griping and sickness.

ANTHELMINTICS,

Or medicines for killing or expelling wonns, naturally
arrange themselves after cathartics, which are indeed the
most effectual vermifuges. There can be little of theory
either in the classing or describing these drugs ; it is all
mere empiricism, or, in other terms, it is chance and
experience only, not doctrine, that has instructed us in
the use of vermifuges ; and the assumption of this de-
partment of practice by old women and charlatans, is less
culpable, and every way more innocent, than when they
profess to cure cancer or scrophula, and other incurable
diseases.

There are yet obvious distinctions among anthel-
mintics, since we can distinctly perceive, 1^#, That
some, especially the drastic and mercurial purges, huiTy
the insects through the intestines, the rapid action of
the bowels weakening theiL adhesion : such are purges
of gamboge, jalap, scammony, and submurias hydrargyri.
2d/?/, That there are others which poison the worms,
weaken cheir hold on the viUi of the intestines, and force
them, in order to escape the bitter or other poison, to
coil themselves up ; and when thus intwined in knots
one with another, and imbedded in mucus, they give
way to the motion of the intestines, and are carried along :

li

SANTONICA.

99

Such are fern, santonica, cabbage-bark, tanzy, garlic,
camphor, &c. 3rfZi/, Other anthelmintics, again, as Fir,
operate actually by their mechanical properties, disturb-
ing and hurting the insects, till they are ready to quit
their hold, which happens during the operation of a
purge. Uhly^ Filially, those worms which reside in
the lower intestine are quickly suffocated by the injec-
tion of olive od simply, or are poisoned by injections of
camphorated oil, garlic infusion, assafoetida, or lime-
water and oil.

List of Anthelmintics.

1st, Bitter Vermifuge Medicines.

Santonicum,

Tanacetum,

Polypodium Filix MaSj
Spigellia Marylandica,

Murias Sodae,
AUium Scepa,
Camphor,
Aqua Calcis.

Mechanical Vermifuges.

ti .

Stanum, Oleum Eiiropa?^

Dolchicum, Cow-Itch,

Anthelmintic Purges.

ji

Gambogia,

Geofirea,

Veratrum, vel HeUe-

. li -ti-

borum Album.

— ^ — Artemisia santonica, 1 mention first,
not as the most powerful, but as the most famihar
prescription, called worm-seedj par excellence. This
powder consists of the seeds and tops of an unknown
shrub, brought to us from the Levant of a^ whitish-
brown colour, a bitter and acrid taste,^'and hardly any
smell. It is chiefly used against lumbrici., and chiefly

G 2! '

I

100

MALE-FERN.

in children ; and is given in the morning, on an empty
stomach, in doses of ten, fifteen, or twenty grains, ac-
cording to the age of the child ; to the adult we give
one scruple. It is needless to speak of giving infusion
of so intolerable a bitter to children, it can be effica-
ciously used only in powder, and the powder must be
carefully involved in treacle, or in marmalade, jelly,
honey, &c. or diffused in milk, and washed down with ,
a little milk : And it is to be observed of this medicine,
that it is so excellent a stomachic bitter, that where we
have mistaken the disease, the medicine is useful ; and
where there are worms, while these are poisoned and
expelled, the bowels are strengthened.

Neither Santonica, nor any anthelmintic, is to be con-
joined with purges, but alternated with them. Of
the powder of santonica, a scruple, or half a drachm, is to
be given every morning ; and every fifth or sixth morn-
ing, a smart purge of calomel, jalap, or gamboge.

It is not to be forgotten, that anthelmintics, like purges,
should be combined one with another ; a half dose of
santonica is not unfrequently combined with a half dose
of pidvis stanni, or of valerian, or with a grain or two \
of sulphate of iron, or a few grains of muriate of ammo-
nia ; and on the day of giving the purge, a sharp glyster
of senna, or salt, is thrown in to aid its operation. ,

Polypodium filix mas, male-fern. —

The root of the male fern, a very common plant, runs
horizontally with many fibrillas, striking down from those
leaders into the sod. It is the big horizontal root,
that is cut short, dried, and preserved for use. It has no |
smell, little bitterness, a soft and mucilaginous taste ; so !
that with qualities so little obvious to sense, its efficacy in j
killing the toenia (it is expelled by the purges whicli
are given along with the fern) is as surprising as it is
unquestionable. The use of the male fern, has been in

CAROLINA PINK.

101

various, and even remote ages, a secret, and a success-
ful one ; and being in the hands of quacks, its use has
been resolved into a distinct and circumstantial process.
The patient is to take of an electuary of the fern root,
combined with pulvis stanni, jalap, and poUychrest salt,
a tearspoonful every two or three hours, for two days ;
and on the third day, he is to take a table-spoonful of
castor oil, or a dose of jalap and scammony ; and during
his course, and until the worm is expelled, he is to live
on spare diet, chiefly bread and soups.

The male fern was the medicine used by Madame Nouf-
fer, one of the proprietors of the secret cure for the Toenia.
Two drachms of the powder of the dried root of fern
were directed to be given very early in the morning ;
and two hours after, the patient had a bolus given him
of six grains of calomel, with ten of gamboge, drinking
after it a basin of green tea, repeating the draught, in
order to promote the operation of the bolus : the patient
was directed to take soups only during this experiment,
and usually voided the worm, or some proportion of it,
the first day, and the whole by a repetition of the process.

The spiGELiA MARYLANDiCA, or Carolina

Pink, is an anthelmintic of a more dangerous descrip-
tion, chiefly used against the lumbricus, or common
worm of the intestines. It is the root of the plant that
is used in the form of powder : it may be supposed to
affect the worms, it almost poisons the child ; its most
conspicuous effects are exciting, as some of the other
narcotic poisons do, vomiting and purging. The effects
of the American pink, resemble those of the more dan-
gerous narcotics ; it causes vertigo, confusion, dimness of
sight, and dilated pupil, in so much that, during its use,
the child must be kept in a dark room, the pupil being
strangely dilated, while the eye and brain preserve their
sensibility. This is more peculiarly the effect of a species

102

SEA SALT. — ^GARLIC. — LIME WATER.

of the spigelia, which grows in the island of Dominic,
and is used in form of syrup, made by infusion in boil-
ing water.

The root of the pink may be given in doses of half a
drachm to children ; fifteen grains, morning and even-
ing, is a sufficient, and sometimes a dangerous dose :
When it proves purgative, the patient parts with lum-
brici often in great numbers ; if it fail to purge the pa-
tient, or if it cause nervous symptoms, such as have
been already mentioned, its operation must be hastened
by other purges, which bring away the lumbrici, and
put a period to the dangerous symptoms. This medi-
cine I regard as a dernier resort, never safe, and not to
be familiarly used.

Tanacetum, tanzy, the flower and leaf

next to santonica, or worm seed, is the most familiar
vermifuge. It is a bitter so nearly resembling santonica,
as to be often substituted for it ; it is a medicine merely
popular, being superseded by the more intense and
powerful bitters.

Murias sod.®. Common Salt, Culinary

Salt, poisons worms; it so sickens them, that, like
leeches, to which salt has been applied, they shrink and
lie coiled up, ready to be expelled. A drachm of sea-
salt disguised, and given dissolved in water early in the
morning, has often an incredible effect.

Allium, garlic, is another excessively

acrid medicine, especially efficacious in poisoning worms,
and leaving them coiled up and exposed to tlie hurried
action of the intestines, by which they are expelled.
The best infusion for such purposes, is an infusion in
milk ; an ounce of garlic is bruised, mixed, and infused
with a pound of milk, and given as drink, or used as im
jection.

rr^rr- — WATER has the same properties, and

TIN. — COWHAGE.

103

is especially useful in desti'oying ascarides in children.
The injection of three or four ounces of lime water,
with which is often conjoined a third of oil, is very ef-
fectual.

— « — — Stannum, tin, is one of those vermifuges,
which having neitha* chemical properties, nor sensible
operation, cannot be imagined to act on any other prin-
ciple than by its mechanical effect, of destroying and an-
noying the worms so as to displace, or preventing them
from retaining their hold ; for it is used chiefly when
toenia is suspected. We need say nothing of the mine-
ral condition, nor chemical properties of tin ; it is not
by those it operates, it is not a medicine to be given in
delicate doses ; the quantity, we should rather say the
load of it, that is required, proves how entirely it ope-
rates by its bulk, and mechanical properties ; it has been
more used in Scotland perhaps than in any country. It
is the adult chiefly, that is afflicted with the toenia ; and
to the adult one ounce of the pulvis stanni, (of the simple
powder of tin, produced by shaking tin while melted in
an iron box till cool), one ounce is prescribed mixed up
with treacle, or any other viscid saccharine matter : half
is given the first day, an ounce the second day, and the
same quantity the third day ; after which a sharp ca-
thartic is prescribed ; (some choose to give a strong ca-
thartic also before beginning to use the tin) ; after which,
the joints and fragments of the toenia begin to be dis-
charged.

Dr Alston’s coarse prescription of an ounce of tin pow-
der, mixed up with treacle, is refined by modem prac-
titioners into an electuary of powder of tin, with con-
serve of roses and syrup, and it is given in very mode-
rate doses.

Dolichos pruriens, Cowhage.— This^ is

the pod, three or four inches long, of a West India creep.

104

OIL. — CAMPHORATED OIL.

ing plant ; the outside of which is thickly beset with
stiff brown hair : The ripe pods are dipped in syrup and
scraped with a knife, till the syrup, from the hair being
doughed and caked into it, becomes a thick pulp;
then it is fit for use : Those hairs cause an intolerable
itching in the hands of those who handle the pod ; and
when taken inwardly, it no question acts mechanically
on the worms, for it no way affects the bowels. It is
given three tea-spoonfuls in the morning fasting to a
child, or in a larger dose according to the patient’s age ;
and this (hke every other anthelmintic which destroys
or weakens the worms) is purged off after the third dose
by a brisk cathartic. Some prefer giving the dolichum
at night, and following it with the purge in the morn-
ing. It is chiefly against lumbrici that this vermifuge
is used, yet it is found equally noxious to the tcenia.

• Oil is found to be very universally noxious to

W'orms, insects, &c. whose respiration is stopped by behig
involved in it. Oil is a sure resource against ascarides, be-
cause, being injected into the rectum, tlie worms are suf-
focated, and immediately die ; and oil, though not so
surely effectual when given by the mouth, yet is used
so, being usually combined with a very small proportion
of the aqua ammoniae, or with a small proportion of
aromatic tincture, of compound tincture of gentian, &c.
Oil, when taken internally as a remedy for worms, should
be taken in doses of three or four table-spoonfuls, or
indeed as much as the stomach will bear : Also, it

should be given on an empty stomach in the morning.

Oleum camphoratum, is the last of these

poisons we have occasion to mention. Two drachms of
camphor dissolved in four ounces of oil, makes a poAver-
ful anthelmintic injection : Little more than three ounces
of such a glyster is fairly delivered : It may be injected
into the rectum every second or third pight : it usually

anthelmintic purges.

105

remains all night, alleviates the itching and irksome
feeling proceeding from the ascarides, and comes away
in the morning, bringing the dead ascarides along with
it. Injections of lime-water should be used in the in-
termediate days.

The remaining anthelmintics are the drastic purges
appropriated to this process, of expelling worms already
sickened or killed by proper anthelmintics ; They in-
deed are often expelled in numbers quite incredible, (es-
ecially from the children of the sickly poor), coiled up and
imbedded in thick mucus, as if they were actually baked
with it into a clay-coloured mass like a swallow’s nest.

Among the principal of these anthelmintic purges, is
Gamboge, which, though poisonous, cannot in so small a
quantity be supposed to affect the worm ; but as the opera-
tion of this medicine is in the upper part of the canal, ex-
citing vomiting as readily as purging, it operates most ef-
fectually towards the expulsion of theToenia, whose seat is
chiefly in the stomach and upper intestines. Subcarbonate
of potass is in some sort an antidote to gamboge, and should
always be conjoined with it, triturated and in form of
powder : six or eight grains of gamboge should be given
every two hours, till the lumbrici, (if that be the worm),
or some portions of the toenia, are expelled. Or in the
case of the decided existence of tcenia, the medicine
may be given early in the morning, in the full dose, what
might be supposed an excessive dose, of fifteen grains
or a scruple.

Geoffrce.® inermis. Cortex. — The Cab^

BAGE-TREE BARK, is a poisonous veimifuge, which, be-
sides operating as a drastic purge, often occasions vomit-
ing, sickness, and delirium, either when given impru-
dently, or from drinking cold water after it. Those
alarming symptoms are appeased by a draught of tepid
water to dilute, or a purgative dose of castor oil to ex-

106

CABBAGE-TREE. — HELLEBORE.

pel the medicine. But such symptoms are frequent,
and have prevented the general use of the medicine in
this country ; we have many preferable, and some
stronger and safer anthelmintics. The cabbage-tree is
thence used chiefly in the West Indies, where it grows.

This bark is of a grey colour like jalap, has a mucila-
ginous sweetish taste, and unpleasant smeU ; is some-
times given in form of powder, but more safely in form
of decoction, which is made by boiling an ounce of bark
in a quart of water, till it is of a deep yellow or reddish
colour. This decoction, sweetened with sugar into a
sort of syrup, is given in smaller doses ; at first, a table-
spoonful only to a child, gradually increasing the dose
till nausea forbids the further increase of it : after pro-
ducing nausea, it purges violently, and the lumbrici are
soon expelled.

The VERATRUM SABADiLLA is another

poisonous and drastic medicine, much commended as a
remedy against the toenia. Dangerous in itself, it is
sometimes sophisticated with a drug still more delete-
rious, viz. the veratrum album. The veratrum saba-
dilla provokes vomiting and intense purging ; it may
be given with honey or syrup, in doses of three grains
to a child of four years old, five grains to a boy of ten
years old, and in doses of ten or fifteen grains to an
adult. This also is of the order of poisonous vermifuges,
which we use less willingly. But mth so full a catalogue
of anthelmintics, and ranking among them all those
specified in the letters patent of Empyrics, there is
surely no apology for resorting to advertised worm-pow-
ders or cakes.

siJdoeifics and diaphoretics.

107

Fifth Class.

OF MEDICINES, OR COMBINATIONS OF MEDICINES, CAL-
CULATED TO PROMOTE THE PRINCIPAL SECRETIONS
OF THE ANIMAL SYSTEM ; DIAPHORETICS, DIURETICS,
EXPECTORANTS, EMMENAGOGUES.

It were very rash and presuftiptuous to affect to say,
by what specific operation one medicine provoked inine,
another sweat, and another expectoration ; but we per-
ceive very distinctly, and it is for that reason that we
divide sudorifics, for example, into classes, that one dia-
phoretic medicine is suited to inflammatory, another to
febrile, and a third to rheumatic diseases, or to disorders
of the intestinal canal ; that one soothes, while another
excites and heats the body ; that one is mild, and dia-
phoretic only, while another is sudorific, and bathes
the patient in perspnation : Thence it follows, that skill
in selecting and appropriating medicines to their respec-
tive diseases, is as indispensible in this as in any class of
prescriptions.

SUDORIFICS AND DIAPHORETICS,

Are medicines used chiefly in the adult, and very
rarely in children ; and they are not, as would at first
appear, medicines of very general use ; they are, on the
contrary, prescribed only in a very few diseases. In
Ephemeris, or one-day fever, in Continued fever, and in
Intermittents ; in Rheumatism, in Lues venerea, and in
Paralytic diseases ; also as alteratives in eruptive diseases,
and in chronic disorders of the bowels, as diarrhoea, or
dysentery.

jit is not, I am persuaded, by the quantity of fluid

108

OF THE SECRETIONS.

evacuated, nor by any thing peculiar in the secretion,
far less (though the older physicians believed it) by car-
rying off the morbific matter of fever or dysentery, or
the arthritic matter of gout, that sudorifics are of use ;
but by restoring the quiet and moderate action of the
vessels of the skin, and by keeping them full and se-
creting. AU that we do know of diaphoretics, vindi-
cates us in this opinion : That morbific matter should
be fermented, as it were, to a state of maturity, sepa-
rated from the mass of fluids, prepared for §ecretion,
and then secreted, is merely a visionary notion of the
old physicians, who resorted to such theories, and wrote
long and wearisome volumes on the concoction of mor-
bific matter, only from not having a simple and philo-
sophical conception of the operations of the animal
body.

One thing is manifest, that the secretions of the
skin, of the trachea, of the glands in various parts of
the body, as the kidney, the testes, &c. never go on
happily ! that surfaces such as those of the urethra, tra-
chea, and skin, never secrete while in a state of high
inflammation. When the skin is burning hot from the
intense action of its vessels, the perspiration stops, and
the surface is dry and hard : — when the urethra is in-
tensely inflamed, the gonorrhoea stops, and the testicles
swell : — when the trachea is inflamed, the patient is
hoarse, suffocating, and miserable ; but he is relieved as
soon as the secretion is relieved. Secretion is a healthy
action, inconsistent with the inflamed condition of the
part ; and it is to be restored and augmented, chiefly by
the soothing influence of warmth and moisture, and the
gentle operation of anodynes and narcotics. According-
ly we find, that all medicines which appease violent vas-
cular action, bring on perspiration ; that antimony,
ipecacuanha, and opium, are our most powerful sudo-

CATALOGUE OF SUDORIFICS.

109

rifics ; said that the operation of every sickening dose
of an emetic, of every powerful narcotic, and of all
poisons, ends in sweat.

The principal diaphoretics are. Emetics, Narcotics, or
Neutral Salts, and Stimulant Gums ; and the best assist-
ants are, moderate warmth, diluent drinks, baths, and
friction. The catalogue of Diaphoretics, not indeed
very numerous, but very important, may stand thus :

1. Antimony.

2. Ipecacuanha.

3. Opium.

4. Ammonia.

5. Nitras potass^.

6. Acetas ammonia.

7. Citras ammonije.

8. Camphor.

9. Aconitum.

10. Guaiacum.

11. Sassafras.

It is natural to imagine, that those emetics, and salts,
which operate by their sedative powers, are more suit-
able to fevers and inj0ammatory diseases ; that the more
acrid sudorifics, as Guaiac and Sassafras, should be more
useful in chronic rheumatism, and syphilitic disorders.

1^^, In the first attack, in the cold stage and shivering
of a slight fever of ephemeris especially, or one day
fever, or when, a patient suffering under intermittent,
we wish to anticipate the paroxysm, or to bring it to a
crisis by profuse perspiration ; the process is conducted
by giving a heavy dose of our most powerful sudorific,
viz. opium, and ipecacuanha, with plentiful drinks of
white wine whey, or weak wine and water, or gruel
with a small proportion of spirits : Or we give, in the
evening, an emetic, and at bed-time a powerful opiate ;
or we give a draught of antimonial wine with opium :
and thus, by a full emetic, which brings on perspiration,
or by a powerful narcotic, we prevent fever, or stop
the paroxysms of an intermittent.

110

THEORY OF CLASSIFICATION. -

2c?, In the circumstances just enumerated, we mean
to procure sweat profuse and critical ; but in continued
fever already formed, we do not proceed thus : we pro-
pose to procure diaphoresis, and support a perspirable
state of the skin, by gentle means; not by opiates,
hot drinks, or warm baths, but by imperceptible opera-
tions of antimony, of camphor, of saline draughts ; and
these must aU be delicately administered, especially in
fevers attended with inflammation of the skin, the
throat, or the joints. In such diseases, we do not urge
perspiration by Dover’s powder, nor any other prepara-
tion of opium ; for those but inflame the skin, making
it hot and dry, and raise the pulse and disturb the
brain, the patient being already inclined to delirium ; —
Far less do we urge perspiration by hot baths, or by

heaping bed-clothes upon the patient: We find, on

the contrary, that a gentle diaphoresis, such as clears the
head, and calms the pulse, is best procured by small
and frequent doses of nitre, camphor, and antimony*
and is most favoured by a cool condition of the skin*
and by a free circulation of air. Antimonials, neutral
salts, and camphor draughts, or powders ; draughts of
the acetas ammoniee, and citras ammoniae, are the most
natural, gentle, and kindly diaphoretics, in continued
and inflammatory fevers.

Sdy It has always appeared to -me, that those intense
sudorifics, and acrid medicines, which we prescribe, not
in febrile, but in chronic cases of rheumatism, syphilis,
or dysentery, are a distinct class of drugs, having a very
different operation. They are stimulants, of a hot and
fiery nature ; they require the co-operation of vapour-
baths, friction, and other stimulants, such as turpentines
internally, and sinapisms and spirituous applications
externally ; and they are given in diseases, viz. rheuma-
tic and syphilitic pains, which are disorders of the
nerves chiefly, first of those nerves which are appro^

SUDOEIFICS ARRANGED AND ENUMERATED. Ill

priated to the musdes, and next of those which termi-
nate in the joints and periosteum, as may be exemplified
in the Tic Doloreux, where there is pain only, and in
Toothach, when suppuration follows from an affection
of the bone.

The sudorifics useful in paralytic and rheumatic
affections, are, pulvis doveri, aconite, guaiacum,
SASSAFRAS, and AMMONIA. — Of the medicines used
as diaphoretics, some of the most powerful have not
yet been described; the chief of those are, pulvis
IPECACUANHA COMPOSITUS, ACONITUM, GUAIACUM,
SASSAFRAS, CARBONAS AMMONIA, LIQUOR ACETIS AM-
MONIA, and ciTRAS ammonia. The aids, serving
to promote the operation of those medicines, are, the
ordinary diluting fluids, as acidulated gruels, given
tepid ; serum lactis vinosum, White Wine WTiey ;
SERUM LACTIS sinapium, or Mustaxd WTiey ; Infusions
of stimulant vegetables, as balm tea, and sage tea,
with PEDiLUViUM, in slight febrile disorders ; and Se-
micupium, or Half Bath, Balneum Calidum, or the
FuU Bath, and Balneum Vaporis, or Vapour Bath ; all
which, especially the vapour bath after the manner of
the Russians, and the hot sea-baths, or Baths of Hy-
drosulphuret, are of singular efficacy in chronic disorders
of the joints, from gout or rheumatism, as the waters
of Bath or Buxton.

Pulvis ipecacuanha compositus, the com-
bination of a powerful narcotic with a sickening dose of
an emetic, and a portion of neutral salt, (Nitras Potas-
s£e), combines almost all that is effectual in promoting
perspiration. I find it right to regard this combination
as a distinct medicine : I cannot imagine a more infal-
lible sudorific, or a more powerful one : after a dose of
fifteen grains or a scruple of this powder, the patient
lies bathed in sweat. — But it is necessary to stop and

*112 DOVER’S POWDER. — ^ACONITE.

remark certain reservations ; for this is a medicine cer-
tainly not to be used in inflammatory fever, in exanthe-
matous diseases, in disorders of the head, nor in very
athletic habits; for wherever there is intense arterial
action in an athletic constitution, Dover’s powder sickens
the patient, often produces intolerable itching, and in-
creased redness and hardness of surface ; often confuses
the head, and after all this disorder brings no relief, but
leaves headach, languor, and thirst. ^

PuLvis DOVERi, is a medicine useful on

the fii’st attack of fever; particularly useful in pre-
venting the paroxysm of an intermittent fever ; in
dianiioea and dysentery, it is useful, not as a sudorific,
nor in a full dose, but as a diaphoretic in minute doses ;
and it is useftil in chronic rheumatism, especially to be-
gin the cure. But it is a medicine never to be given
without inquiring whether it disorders the patient, for
there are many who cannot endure Pulvis Doveri with-
out sickness, vomiting, itching, and extreme disorder of
the whole frame : to some it is as a poison.

Aconitum neomontanum, aconitum

NAPELLi, is at once a deep narcotic, and a very acrid
poison : It causes trembling and paralysis of the limbs,
and a paralytic relaxation, and convulsive motions, of
the countenance. In regard to the stomach and bowels^
- its operation is very rude, causing vomiting, purging,
and a painful swelling of the tongue and fauces. It
leaves a strong impression of acrimony on the tongue,
and from its nauseous smell, and very peculiar taste, we
refer it at once to the class of acrid narcotic poisons.
The dried leaves are perliaps the best form ; the extract
is most commonly used ; the tincture (made by infusing
one part of the dried leaves in six parts of alcohol) is a
very safe form, and, like the infusion of other narcotics,
is given in doses of fifteen drops, three or four times a-

GUAIACUM.

113

day : Of the Extractum Aconiti, a grain or a grain
and a half may be given, rubbed down with fifteen
grains of sugar, and an equal quantity of cream of tai-
tar, or of nitre. Its best uses are in gout, rheumatism,
and syphilis ; in venereal nodes, and in herpetic sores :
It is best given in combination \\dth a small portion of
antimony, with the aid of warm salt baths, or vapour
baths, to determine its operation to the skin.

Guaiacum is an indigenous tree in His-
paniola, Jamaica, and the Brazils : The wood, the bark,
and the resin, are used ; when chewed, it gives a pun-
gent, acrid, bitterish taste, leaving a dryness in the
fauces and mouth : It stimulates and warms the whole
frame ; it excites the pulse, and, favoured by a gentle
heat of the bed-clothes, and the use of warm diluents,
it brings on perspiration, not very profuse, but very
gratifying, for it alleviates the pains of rheumatism and
syphilis, and by perseverance cures them : If long con-
tinued, it salivates. It is chiefly useful in gout, rheuma-
tism, venereal nodes, and nocturnal pains ; in oezaena,
and ulcerations of the fauces ; and in cutaneous diseases.

These, indeed, are the virtues of all this order of acrid
sudorifics ; the decoction so much used in syphilitic dis-
orders, is far the least valuable preparation, and the
least certain in its effect ; it is made by boiling an ounce
of the wood or root in two pints of water, which quan-
tity of decoction should be taken at successive draughts,
in the course of the day. — But the surer and more
powerful preparations are, the resin and the tincture.
The formulas for these allow of various useful com-
binations : — The tincture may be mixed in the propor-
tion of half an ounce with three ounces of any distilled
water, for a diaphoretic draught ; — an emulsion may be
ordered with the extract, so proportioned as to convey

VOL. m. H

114.

SASSAFRAS. — AMMONIA.

thirty or forty grains in the twenty-four hours or the
same dose, viz. half a drachm of the resin, may be so
divided into pills, as to be taken in the course of the
day ; and this last is the most manageable form of pre-
scription, since it allows of combinations of guaiac with
opium, with Dover’s powder, and with antimonials.

Sassafras is a tree of America and the

West Indies, having a strong, not unpleasant smell*
and an aromatic taste, somewhat acrid. The wood*
root, and bark, are aU used, but chiefly the wood, in
chips. It is best used in infusion, or decoction, and
chiefly in combination with other woods of the same
stimulant qualities. It is stimulant and heating ; ex-
cites a gentle perspiration ; is pecuharly usefiil in rheu-
matism, gout, syphilis, and amenorrhcea : and in herpes
and cutaneous sores. It is seldom used alone ; the best
and most usual combination is that formerly entitled
Decoction of the Woods, viz. one part of the root of
sassafras# three of chips of guaiac, with a proportion
of dried resins and liquorice root, boiled in water.

Amimonia. The Carbonate of Ammonia

has been mentioned as an antispasmodic, perhaps it
should have been arranged as a stimulant : By its sti-
mulant power, it enforces the operations of the more
acrid sudorifics, and is most appropriated to that species
of rheumatism which is attended with a paralytic debi-
lity of the limbs.

These ai*e the acrid sudorifics, used in chronic dis-
eases ; but for gentle diaphoretics, such as may, without
heating the system, be given in febrile and exanthema-
tous diseases, and in inflammations, we use only saline
draughts. The chief of these, celebrated as a gentle
diaphoretic and febrifuge, is the acetas AMMONiiE li-
<%uiDUS, or Sphitus ISIindereri.

Acetajs ammoni.£ is formed by the di-

ACETAS AND CITRAS AMMONIA. 115

rect combination of vinegar with ammonia, or volatile
alkali ; and the various processes resorted to by chemists,
have no other intention than to procure it pure, and of
an ascertained strength. As it is usually prepared, one
ounce of liquid contains one drachm of subcarbonas am-
moni£B. — It is used as a cooling and gently diaphoretic
draught, in continued fever, exanthemata, acute rheu-
matism, and angina. It loosens the bowels, if taken in
great quantityj proves diaphoretic if tlie patient be
kept moderately warm, diuretic if kept cool, and it al-
ways proves sedative.

CiTRAS AMMONITE. The neutral solution,

produced by mixing the citric acid with ammonia, is a
still more pleasing prescription, not officinal, but com-
pounded for the occasion with any distilled water, and
given very usually in the state of effervescence.

This word pleasing reminds us, that this, and many
similar prescriptions, are regarded almost universally as
mere placebos. If it were so, and that these were mere-
ly placebos, the usage of giving such from hour to hour
might be vindicated on this ground, that it is right not
to allow ourselves to seem wanting in resources, only
because we think it "wise for a time to do nothing. By
giving even a placebo, we retain the confidence of our
patient, both for ourselves and for our art. But this is
far from the truth ; these, though not violent medicines,
are not mere placebos ; they have aU the quahties of
neutral salts, proving cooling, refreshing, diaphoretic,
and laxative ; they are peculiarly adapted to that state
and stage of continued fever, in which there is a slight
tendency to delirium, a smart re-action of the pulse, a
dry and hot skin, but nothing malignant. At such
' time, our business is to temporize, to alleviate symptoms !

I we have nothing to fear but from officiousness ! we give
cooling draughts, gentle anodynes, and daily laxatives.

JT 2

I

116

WHITE MMNE AND MUSTARD WHEY.

This is especially our practice in the fever of growing
boys and girls, a fever produced by fatigue, acting on
the delicate and irritable system in youth.

To assist the operation of diaphoretics, the Serum
Lactis Vinosum, White Wine Whey, is rarely omit-
ted ; and to promote the operation of the more power-
ful sudorifics, of Guaiac, Sassafras, and Aconite, in
chronic rheumatism, lues, and paralysis, we use a more
powerfiil stimulant, which not only fills the vessels, but
excites them, — the serum lactis sinapinum. Mustard
Whey.

OF DIURETICS.

The secretion of urine is perhaps the most uninter-
rupted, and the most essential to health : Its varieties
afford the most unerring indications of the condition of
the system ; and the defect of this secretion brings on,
or at least accompanies, the most afflicting diseases,
which are remedied the m.oment this secretion is regu-
lated and perfectly restored. ^

The medicines by which we have it in our power to
affect this secretion, are numerous ; but it is obvious, ;
that diuretics cannot be so uniform in their effects, nor
so easily and simply prescribed, as emetics, purges, or
even diaphoretics. Many are often combined in one
prescription, and various forms of diuretics, and various
drugs, are brought to aid each other ; and often, while
looking for a happy effect from these, we find it neces-
sary to give a favourable impulse to a sluggish and op-
pressed system, by the interposition of emetics, and of
drastic, and, as they are termed, hydragogue purges, as
gamboge, jalap, &c. I

The purging the system of superfluous w^atery ef- jj
fusion, is a more difficult and uncertain process than ,l

OF DIURETICS.

117

any we have hitherto described. There is a ca*
price in the mobilities of the system, and a sort
of chance in our success ; the process is empirical
altogether ; we have nothing but experience to direct
us, yet much discretion and good sense is required in
the conducting of it. One thing is happy, that this
uncertainty relates only to our success, for diuretic me-
dicines are in themselves harmless ; we can hardly do
harm, except in giving cantharides, turpentine, or some
very irritating medicine, in excess ; and even then the
ill consequences come on gradually, and cease very
soon.

There is hardly any form of disease, in which it may
not be necessary to give an opiate to alleviate symptoms,
or to procure sleep ; but I cannot refi^ain from advising
the young physician against the notorious imprudence
and inconsistency, of subduing the living powers of the
system by opium, in circumstances where active opera-
tions are required, when it is his purpose both to excite
the general system, and the particular gland. Opiates
and diuretics seldom harmonize.

Diuretics may justly be divided into two great
classes, according with certain circumstances of disease.

First, In all disorders relating chiefly to the secreting
organ, when the kidney is inflamed from cold, hard
riding, or drinking ; when it has been injured by blows,
or falls on the loins ; when acrid and irritating medicines,
as turpentines, cantharides, &c. have been imprudently
given, mild and gentle diuretics only are required. —
Diluent mucilaginous fluids, and gentle diuretics, saline
draughts, and diluting drinks, are also required when
calculi, having formed in the kidney, afflict the patient
with acute pain, or when the bladder is diseased, or the
urethra inflamed.

Second, But when the general system has gone into

118

TWO CLASSES OF DIURETICS.

disorder, tlie secretion of urine becomes imperfect ; when
dropsical collections begin to oppress the viscera, and to
distend the cellular substance ; when, in spite of the lan-
guor attending incipient dropsy, the patient begins to
breathe with difficulty ; when next he tosses, and cries
out with indescribeable anxiety ; when, no longer able
to breathe in bed, he sits up all night long, his belly
tense, his ankles swollen, his face pale, emaciated, and
hippocratic, the urine high-coloured, thick, and scanty,
the pulse quick, and often very heavy and strong, — the
system is going to ruin ! all paiis of the structure suf-
fering ! all the hving powers subsiding ! and the person
is to be saved only by restoring the secretion, and we
must, without loss of time, ply all our powerful drugs.

These, then, constitute two distinct purposes, and
this order of medicines naturally divides itself into two j
classes, corresponding with the gentle and the drastic
among cathartics.

l6?.

Nitras potass.®.

SUPERTARTRAS POTASS®.
AcETAS POTASS®.
SUB-CAEBONAS POTASS®.

SUB-CARBONAS SOD®.
SUPER-CARBONAS POTASS®.

>

SuPER-CARBONAS SOD®.

•V

Spiritus cetheris nitrosi. ,

These form a class of diuretics appropriated to the
more ordinary occasions of nephritis, gonorrhoea, irrita-
bility of the bladder, &c. and requiring the aid of the
most gentle diluents only, as whey, mucilaginous and oily
drinks, soda water, imperial or dilute solution of cream
of tartar ; and these prescriptions are often conjoined
with opiates, to facilitate the transit of calculous con-
cretions, to soothe disorders of the bladder, or to cure
(as they do contribute to cure) gonorrhoea.

HOW TO COMBINE DIURETICS.

119

Digitalis.

COLCHICUM.

SciLLA.

Gambogia.

JuNIPERUS.

Lytta.

SUBMURIAS HYDRABGYRI.
Terebinthina.

COPAIVA.

These are the powerful and irresistible diuretics, by
wliich we restore the secretion of urine in the most dif-
ficult circumstances. Like narcotics, purges, and other
powerful medicines, they require, to be combined and
assisted ; they require, while they are principal in the
cure, the aid of the more gentle sahne diuretics ; and
all diuretics require for th^ir operation, that full dilu-
tion, which the older physicians were too timid to allow.
This latter class of diuretics, irritating powerfully, and
exciting the organ intensely, admit of no opiates, un-
less when, by excess of irritation, painful symptoms
have been brought on. But I request that it may be
particularly recollected by the young physician, that
those powerful diuretics require the interposition, some-
times of hydragogue purges, as gamboge, elaterium, &c. ;
that often, while the secretion seems to languish, and
that our prescriptions have no longer the effect they
once had, or when, even from the first, they fail of
producing their usual effect, their operation is suddenly
and marvellously promoted by a violent emetic, which
seems to give a new impulse ; or by a purge of com-
pound powder of jalap, or of calomel and scammony,
which, while it brings on frequent watery stools, causes
a sudden and profuse flow of urine also.

There are three saline diuretics of infinite value, with-
out which our art would be of little avail in disorders of
the urinary passages, and still less availing in dropsy :

120

OF SALINE DIURETICS.

those are, Nitras Potassse, Supertartras Potassae, and
Acetas Potassae.

Nitras potass^, or the neutral salt ob-
tained by saturating kali with nitric acid, has the bitter
taste common to all neutral salts, with the peculiar qua-
lity of leaving a sense of coolness upon the tongue, and
a kind of sharpness. Nitre, in large doses of four or
six drachms, or when taken by mistake for purging
salts, causes intense pain of stomach, sickness, vomiting,
discharge of blood upwards and downwards, frequent
fainting, extreme coldness, and death ; and smaller, me-
dicinal doses, from ten grains to a scruple, produce, if
repeated at short intervals, the same pain in the stomach ;
to prevent which, much dilution is required.

The virtues of nifre as a sedative have been already
mentioned ; as a diuretic it is powerful, yet gentle, and
peculiarly adapted to inflammatory diseases, and affec-
tions of the kidney itself. It is the common prescription
in calculous complaints, in nephritis, in inflammation of
the bladder, and in gonorrhoea. It is best given in fre-
quent small doses, from six to eight or ten grains, three
or four times a-day ; and along with it we give diluting
fluids, as whey, lemonade, imperial, i. e. a dilute and
sweetened solution of cream of tartar and water. It is,
in my estimation, a useful, but by no means a very
powerful medicine, one very little suited to the cure of
ascites, or to any gqneral disease.

Supertartras potass.®, I have hitherto

mentioned only as a sedative : it is a useful laxative, but
an invaluable diuretic, since it is in itself powerful, and
makes a pleasing drink, which aids the operation of all
the other more powerfrd diuretics ; and often, when the
more irritating diuretics fail, we find this gentle and
pleasing medicine succeed.

Cream of Tartar is neyer to be omitted in ascites,

SUPERTARTRAS POTASS-®. — ^ACETAS POTASS.®. 121

anasarca, or diseased liver. If given in electuary, it
is to be accompanied with plentiful diluents. It can
hardly be given in excess, for it hardly can do harm.
Half an ounce in the day is the usual dose, half an
ounce of cream of tartar, dissolved in twdve ounces of
water, drunk at intervals. A drachm of cream of tartar
mixed with honey, or with sugar and a little ginger,
or with sugar and a little alcohol or gin, which forms
a very weak punch, or with a smaU proportion of Ma-
deira to prevent its hurting the stomach, is an excellent
form. This dose of a drachm may be repeated four or
five times a-day ; or, having given first a purging dose,
a drachm of the compound powder of jalap, small half-
drachm doses of cream of tartar may be repeated every
two hours, with honey and diluents. Supertartrite of
potass is a medicine which becomes particularly valuable
when combined with colocynth, gamboge, or digi-
talis. '

Acetas potass je, the Acetate' of Potass,

is still more powerfully diuretic, and more of a medi-
cine, than the tartrate of potass. It is the salt produced
by neutralizing potass with common vinegar : It has a
foul colour, and a sharp and cooling taste, and is so de-
liquescent, that it is very difficultly preserved in the
form of salt ; and so slight is the adhesion of the
acetous acid to the potass, that the salt is decomposed
by aU other acids, even the vegetable ; it therefore must
be used in no acid mixture.

This medicine is so powerfully diuretic, as to have
been all along distinguished by the name of sal diure-
Ticus, or Regenerated Tartar : It resembles the super-
tartrite of potass in all but its taste, which is bitter, and
unpleasant ; its properties are, to move the bowels, and
augment the secretion of mine ; and its dose is from

122

OF SODA AS A DlUFETiel

half a drachm to a drachm or more, repeated three or
four times a-day.

This salt is best made, by directly saturating potass
with vinegar ; and the best prescription is, by saturating
from two drachms to half an ounce of potass with vine-
gar, and diffusing it in any vehicle : In short, the ace-
tate of potass is given as every other neutral salt is, and
proves at once an effectual purge, and a powerful diu-
retic. Its operations are promoted by dilution, by lemon-
ade, imperial, and spiritus oetheris nitrosus : Or it is dif-
fused in almond emulsion, whey, milk and water, &c.
Like nitre, it is peculiarly proper in inflammatory dis-
eases of the kidney, bladder, or urethra ; but in dropsy,
it is effectual, beyond all other salts, in procuring a flow
of urine.

These three, viz. nitre, cream of tartar, and diu-
retic SALT, are very valuable, and, when combined
rightly with the more powerful diuretics of the vege-
table tribe, as Digitalis, are irresistible ; unless when
the liver is greatly diseased, or the health utterly ruined,
or when the dropsy proceeds from hydatides.

Next to these, we must mention certain diuretic salts,
which the fashion of the day has made far too familiar
with all classes of people. The debauched youth, the
valetudinary, the hypochondriac, and especially the
calculous patient, take, ad libitum, of the aerated solu-
tions of the alkalis as daily drink, not without frequent
ruin to the stomach, and intolerable irritability of the
urinary passages.

The medicines I mean are the alkalis, Potassa, and
Soda. — Subcarbonas potass^, the mild vegetable alkali,
is perhaps the oldest form of diuretic salt ; for the ashes
of wormwood, salt of wormwood, ashes of broom, &c.
were only aukward ways of procuring and prescribing

AQUA SUPER-CARBONATIS SODJE. 123

the vegetable alkali, or potass. The sub-carbonate of
potass, prepared by burning cream of tartar, is that now
used ; but as a diuretic, it has not of late years been a
favourite prescription. A dose of a scruple more or
less, is taken, dissolved in a large proportion of water,
and repeated three or four times a-day. It is unques-
tionably (so far as it is any thing) a diuretic, but harsh,
coarse, and neither quick nor powerful, nor one which
we dare continue long to use.

Carbonas soDiE. The mild mineral al-
kali is similar to this, having the same bitter, pungent
taste, the same harshness, and the same sole quality, of
slightly augmenting the uiinary secretion. Both these
alkalis are little esteemed, except in their super-carbo-
nated and diluted condition, of super-carbonas potassse,
vel sodae. Yet carbonate of soda is often given to the
poor from economy, and to the wealthy, when they
find it difficult to drink profusely of soda water, in the
form, prescribed by Dr Beddoes, of soda pills.

Aqua super-carbonatis potass^, pot-
ass dissolved in water, and super-saturated with carbonic
gas, by the operation of Nooth’s machine, is the Me-
phitic Alkaline Water, or the Aerated Alkaline Water,
now so much used, or rather, to speak truly, so much
abused. This is the solvent (for it is reputed such) so
much given in nephritic cases, and in calculi of the uri-
nary bladder : From six to eight ounces of this water,
morning and evening, is the usual dose ; it is by many
taken in hot milk, which at once hides its acrimony,
and promotes its operation ; for milk is the fluid most
used to smoothe the acrimonious taste of the alkalis,
and especially of lime water. When it occasions pain
in the stomach, eight or ten drops of laudanum must
be added to each dose, as in Perry’s Lithontryptic.

^Aqua super-carbonatis soDiE, is the

124-

abuse OF DIURETICS.

super-carbonated solution of soda, made in like manner
by the help of Nooth’s machine. The proportion of
alkali is slight ; the proportion of carbonic gas makes
the liquor brisk, refreshing, and exhilirating ; \idth some
it is actually intoxicating. Though it is not diuretic in
that degree, to prove of special use in draining away
the waters of dropsy, it is, as a gentle diuretic, useful
in nephritis, in slighter complaints of the bladder, in
gonoiThoea, and in calculous complaints ; though it can-
not act as a solvent, it assuredly proves anodyne.

This is a truly fashionable medicine, drunk as profusely
by young gentlemen, having no ailment under heaven,
save idleness, intemperance, and frequent intoxication,
as by those who are diseased ; and is in as great request
in coffee-houses, fruit-shops, and taverns, as ice. The
hypochondriac, the nephritic, the dissolute, equally use
it ; and such pernicious excess in the use of diluents,
and saline diuretics, we see daily producing the most
unpleasant consequences, debility of stomach, and irri-
tability of the minary organs.

Used discreetly as a medicine, it alleviates the pains
of calculus, and cures the less formidable disorders of the
kidney and bladder. But I protest, that I know of no
greater folly, that that of continuing to take medieine as
common drink.

The SPIRITUS CETHERis NiTROSi. — The

Sweet Spirit of Nitre, is much resorted to in nephritic dis-
orders, and in those exanthematous diseases, as Scarla-
tina, which so often in children, during the epidemics
of particular seasons, terminate in anasarca. It is ex-
cellent for promoting the operation of more powerful
diuretics, and for restoring the secretion of urine in
slight fevers ; it is particularly prescribed in arabic or
ahnond emulsions.

Digitalis, whose narcotic powers we

OP THE administering OP DIGITALIS. 125

have chiefly noticed, is among the most powerful diu-
retics : We use it ten times as a diuretic, for once that
we use it as a narcotic ; and the forms which we prefer
for this effect, are those of tincture or infusion. — Some-
times it is given in powder, in doses from half a grain
to a grain and a half, or as far as two or three grains.
—The WATERY INFUSION is made, by pouring eight
ounces of boiling water upon one drachm of the leaves,
and continuing the infusion for five hours. One ounce
of alcohol, spirituous cinnamon water, &c. is added to
the strained infusion, to preserve it ; and half an ounce
of this infusion may be given three or four times a-day.

The Spirituous Tincture of Fox-glove is made by
infusing an ounce of the dry and coarsely powdered
leaves, in eight ounces of alcohol, and placing the in-
fusion by the side of the fire : the infusion is to be con-
tinued eight days, and then strained off for use. This
tinctiue may be given in doses of from fifteen to twenty
drops three or four times a-day, gradually increasing the
; ' dose to thirty, forty, or fifty drops, which dose is usually
|| conveyed in a draught of peppermint, with syrup, and
nitric cether. The urine often is not increased, nor
changes its complexion, notwithstanding the free use of
diluents, for two, three, or four days ; but it usually
happens, that the first violent purge that is accidentally
given, or vomiting excited, as it often is by the medi-
cine itself, so rouses the living powers, that the urine
flows profusely, and suddenly the belly becomes flab-
by and relaxed, and the swelling of the ancles disap-
pears.

This medicine has little effect, unless given in dan-
• gerous doses : It is used in circumstances which suffi-

ciently vindicate any, even the most desperate experi-
ment. But when, without exciting a flow of urine, it
produces Vertigo and blindness, sickness and purging.

126

COLCHICUM. — squills:

#

fainting and extreme lowness of pulse, it must be with^-
drawn, and the patient restored by the use of warm
wine and opiates.

CoLCHicuM AUTUMNALE, or Meadow

Saffron, a bulbous root with stringy fibres, is reputed a
very powerful, and certainly must be, a veiy acrid diu-
retic ; but it is little used, and thence seldom prepared
in this country. Oiu- opportunities, or temptations to
use it, are very rare : it is so acrid as to occasion a burn-
ing heat in the stomach and fauces, tenesmus, and
strangury : it seems to be that medicine, which ap-
proaches nearest of the vegetable tribe to the operations
of cantharides. In the early season it is extremely acrid,
ijj the end of autumn almost inert : The syrup of the
colchicum is the only officinal preparation, and is some- |
times given in doses from a drachm to an ounce in
dropsy.

ScilLa maritima. Squill, a large bulbous

root, is indigenous in Spain and Portugal, and in
Syria. It is of a ffeshy texture, consisting of reddish,
and thin flakey scales, with a whitish acrid juice, of
exti*eme acrimony and pungency, exciting salivation
and sickness from its acrid principle. So great is its
acrimony, that there is no secretion it may not be said
to affect : it excites vomiting in larger, and purging in
smaller doses ; urine, expectoration, and salivation, when
given slowly ; and when externally applied, it acts as a
blister : Though chiefly used as an expectorant, it must
be recorded here in its order as a diuretic. — In dropsy it
is used along with other remedies in a solid form, in piUs,
combined with calomel ; the pills, conveying usually a
grain of calomel with three of dried squills, ai*e given three
or four times a-day. Sometimes this combination aug- '
ments the secretion of urine, and moderates the pulse :

But it is my persuasion, that the process of drying squill

gamboge as a hydragogue. 127

so affects its virtues of every kind, that I have little faith
in this preparation.

SciLLA RECENS, the raw and fresh

Squill, is a preferable medicine, and may be given
in doses from eight to fifteen grains. — The oxymel
of squills, is a medicine more naturally used in asth-
matic and pulmonary complaints. — The vinegar of
squills, acetum scilliticum, is the most universal form in
which this medicine is used, holding dissolved the acrid
efficient principle of the squill in the most permanent
way : It is more frequently used in pectoral complaints,
though the calomel and dried squill is more used in
dropsy. The dose of vinegar of squills, is from two
drachms to ten or twelve ; it should be diluted in cinna-
mon water, or camphor julep, or arabic emulsion; it
slightly sickens the patient, loosens the belly, and pro-
motes urine ; and when it is found availing in this latter
effect, the dose should be redoubled, and the diluents
increased.

Gamboge exudes from a tree indigenous

in Siam, and some of the Eastern Islands, either from
incisions in the bark, or from pinching and breaking
across the leaves and young shoots, whence it distils in
opaque yellow drops ; and this is the reason of its being
j named gum gutt^. It has neither taste, nor smeU,

1 nor any sensible quality, till, being melted on the tongue
and fauces, it leaves a permanent and strong impression
of acrimony. In dropsy, if given alone, it should be in
doses of three grains, rubbed down with sugar, and re-
peated every three hours ; and it should be accompanied
with cream of tartar, or powder of jalap. It is a very
i useful medicine, in giving a new impulse .to the system,

1 and giving activity to the secretion of the kidney, even
it had been little affected by the largest doses of diuretics
I unassisted.

128

MELOE VESICATORIA.

■ — JuNiPERUS COMMUNIS, is a shmb, all '

parts of which, wood, bark, and bud, and berry, have
diuretic effects. The berries abound most in that essen-
tial oil, in which tliis quality resides, viz. a warm sti-
mulant, and aromatic oil, combined with a bitterish I
sweet, which is yet not pleasant. The juniper berry is j
what gives the distinguishing flavour to gin, and it com- ^
municates, at the same time, the diuretic quality ; but i
this is a poor apology for using ardent spirits in dropsy, ^
which, by exciting too much, stop the secretion. Juni-
per berries infused in boiling water, cooled, sv/eetened, |
and acidulated, make an excellent drink in dropsy.

These are the powerful diuretics and hydragogue
purges best suited to ascites and universal dropsy. But 1
local disorders of the kidney, bladder, and urethra, de- 1
mand a different tribe of medicines, which, though men- |
tioned with strict propriety here, are hardly dim’etics :
They affect rather the manner in which the urine is dc- |
livered, than the actual secretion, and might be almost *
as aptly arranged under the title of stimulants as of diu-
retics. They are cantharides, turpentine, balsam of co- \
paiva, &c. ^

Lytta VESICATORIA, Cantliarides, Spa-
nish Flies, are not so conspicuous for the diuretic powers, |
for I have never observed them to procure a secretion I
of urine, so profuse or instantg^ieous as to entitle the
medicine to rank with diuretics ; but for their sin-
gular influence in those diseases in which diuretics
are most required, especially in local affections of the
urinary passages. — First, it is due to the young phy- |
sician to warn him, that this medicine is more a sti- •
mulant than a diuretic ; a dangerous stimulant, pro- ^
ducing, by irritation of the alimentary .canal, vomit-
ing, severe griping rather than purging, tormina like
those of poison, and bloody stools, frequent calls, or ra-

129

USES OF CANTHARIDES.

ther a continual desire to pass urine, which is rather
sparing and often bloody, with a burning heat, espe-
cially affecting the neck of the bladder. But if the me-
dicine be imprudently continued, or if already too much
have been taken in substance, and hes stiU Im-king in the
villi of the intestines, ulceration of the bowels, tormina,
foetid stools, intense heat and thirst, fainting, convul-
sions, delirium, and death ensue : All which symptoms
are best alleviated by camphor, opium, arabic emulsions,
and oily draughts. Thus, though not decidedly a diu-
retic, the cliief effects of this drug are felt in the urinary
passages ; even a blister of cantharides produces a degree
of this irritation.

, It is next due to the young physician to say, that
Lytta Vesicatoria, though dangerous, is infinitely less
so than is vulgarly imagined, and confidently stated in
professional books. The sixth of a grain in substance,
and five drops of the tincture, are mentioned by practi-
tioners of high celebrity as efficient doses : — what can
this mean ?

Cantharides I have seldom given in any but local dis-
orders, especially of the urethra, or paralytic states of
the bladder ; and in those cases, which not unfrequently
occur, especially in literary men, and those engaged in
studious and sedentary professions, when the bladder has
become capacious beyond the natural size, and delivers
itself easily of one third of its contents, but remains two
thirds full : In gleets, paralysis, and debility, or want
of irritability, (a less frequent disease, no doubt, than
the reverse), this medicine is of excellent efficacy. Tinc-
tura lyttae should often be combined with balsam of
copaiva, or with turpentine; its operation is unques-
tionably promoted by small accompanying doses of lau-
danum, and nitrate of potass, or nitric oether, together
xvith whey and arabic emulsions ; and I know from

VOL. ITT.

I

130

OF TURPENTINE.

much experience, that the medicine may be very safety
given, in doses of thirty or sixty drops, viz. a drachm,
three times a-day. Nor have I ever, m raising it to a
much more copious dose, found it to produce alarming
symptoms : always we have warning of approaching ir-
ritation by diarrhoea, a slight degree of which may be
permitted. I have often found advantage too, in com-
bhiing tinctura lytta; with tincture of liellebore.

In di’opsy it may be given along with the tincture of
digitalis, or with the hydragogue purges, as gamboge
and colocynth : But I find it chiefly useful as a tonic
and astringent, when the dropsy is gone, when the pa-
tient returns to exercise and strong diet, and when only
a degree of leucophlegmatia remains. I am indeed
doubtful, whether it had not been arranged with more
propriety, as a stimulant and tonic, than as a diuretic.

'^REEiNTHiNA, Turpentine, is the bal-
sam, exuding spontaneously, or procured by incision,
from the various species of fir or larch. It consists of
two constituent parts, Resin, which, according to the
mode in which it is prepared, is tar, resin, or burgundy
pitch ; and an essential oil, which, in whatever way pro-
cured, is stiU the Essential Oil of Turpentine. And it is
to be observed, that while the product, especially the
resm, vai-ies according to the manner in which it is
procured or treated ; it varies also in some slight degree,
according to the tree or climate whence it comes.

The Scotch Fir, the Larch, and the Canadian Pine,
are those from which turpentine is chiefly procured.

From the Scotch Fir, the common Turpentine ; from
Larch, the Venice Turpentine ; and from the American
Puie, the Canadian Balsam. The pinus silvestris,
the Scotch Fir, is so treated, that we may, in its pro-
ducts, exemplify all the circumstances affecting them.
Tar, pix nigra liquida, is the resin of the Scotch Fir

. DISTI1.LATI0N OF TURPENTINE.

131

melted out by fire : A hole is dug in the ground, and
billets of the fir, piled from the bottom of the hole, and
raised high above it in a conical form ; a slow and im-
perfect ignition begun from the top, melts and sweats
out the turpentine from the wood in the lower part of
the pile, which is less perfectly ignited ; part of the
wood, and of the turpentine, of course, is thus con-
sumed, in distilling turpentine from that, which is only
heated ; and the proportion of turpentine thus distilled
runs down, while melting, into the lower cavity, black-
ened, empyreumatic, and every way contaminated ; in-
deed it differs little from that procured by distillation
from pit-coal, and contains resin, charcoal, empyreumatic
oil, acetous acid, and a small proportion of essential oil.

• Resin, again, is the slow spontaneous exudation
from the several species of Fir, especially the Pinus
Abies, and Pinus Sylvestris, the Scotch and the com-
mon Firs. White Resin, is that which exudes spon-
taneously in the summer heat ; Black Resin, that
which exudes in winter, from those wounds in the trees,
from which, during the summer season> turpentine dis-
tils ; by slow exudation the essential oil has so evapo-
rated, as to leave the resin with very httle of the cha-
racter of turjientine. The resin of the pinus abies,
•melted and strained through linen, is the Pix Burgun-
dica. Burgundy pitch.

Tui-pentine, Terebinthina, is the summer juice, ex-
uding chiefly through incisions from the various
species of fii’, or larch, and running down into cavities
in the earth, or hollows made to receive it. It con-
tains the two principles, the resin and the essential
oil, or turpentine, in full proportions : It is from this
that the oil of turpentine, which, distilled a second time,
is named rectified oil of turpentine, is procured by
: simple distillation. Five pounds of turpentine, and four

I 2

13a

VARIOUS PRODUCTS^ OF TURPENTINE.

pounds or pints of water, are put into a copper alembic ;
upon applying heat, the oil and water come over to.
gether, and what remains behind is resin. The species
of turpentine used for this process, makes httle differ-
ence in the product. The turpentine procured from the
larch, is that termed Venice Turpentine, and preferred as j
pm’er ; that procured from the pinus abies, or the pinus '*
sylvestris, is the common turpentine ; that from the pi-
ims balsamea, is the Canadian balsam ; the essential oil
procured by distillation, is still the same, oil of turpen
tine.

As for the resin which remains behind, its various
aspects are determined by the manner in which the pro
cess is concluded : If, with the addition of vinegar, it j
be distilled to dryness, it is common resin, or colo
phony ; if, being mixed towards the end of the process
with boihng water, so that part of the water incorporates
with it, it becomes yellow resin ; if melted and strained
through linen, it becomes Burgundy pitch.

Those are the forms of the resin of turpentine, ac>
cording as it is more or less tainted with empyreuma, or ]
other impurities. But the essential oil of turpentine is
still the same : It is the essential oil that is precious as
a diuretic, a stimulant, and a mbefacient. Its use as a
diuretic, is hke that of cantharides, much limited to lo-
cal diseases of the bladder and urethra ; it is especially
useful in nephritis, in lumbago, and in various species of
rheumatism. It may be given in draughts of twenty,
thirty, or sixty drops, repeated twice or thrice a-day,
but never without a profusion of diluents. I find it a
medicine particularly useful in gleet, and especially in
paralysis of the bladder, in women after laborious la-
bours, in men after imprudent distension of the bladder ;
and it is useful in paralysis of the lower extremities, in
dropsy, and in diseases of the bladder. While turpen-

OF COPAIVA.

133

tine is prescribed internally, the lower part of the abdor
men should be rubbed with turpentine liniment.

Spruce-Beer, the extract by decoction from the ex-
treme twigs and buds of the Scotch fir, fermented with
treacle, or with white sugar, which forms a purer beve-
rage, is an excellent diuretic drink, fit to assist the ope-
ration of more active medicines.

CoPAiVA, is the balsam or resinous juice

exuding from incisions made in the trunk of a West
India tree. It is a clear transparent oily-like juice, of a
pungent bitter taste, and a strong turpentine smeU ; it
is acrid, and the taste continuing long after it is taken,
often sickens the patient, while the oil itself, if taken
in frequent doses, acts as a laxative or purge. It is soon
distinguished in the urine by its taste and smeU ; it is of
the same rank with the medicines last enumerated, less
of a diuretic, less fit for dropsy, but highly stimulant,
strengthening, slightly diuretic, and proverbially useful
in disorders of the urethra. It is usually given in doses
of thirty drops twice or three times a-day, dropped on
sugar, or mixed in emulsion. For the dose of this me-
dicine we have no rule, but give sixty drops at first, and
increase or repeat the dose as fast and as long as the sto-
mach will bear it.

OF EXPECTORANTS.

Perhaps there is no class of medicines, which more
particularly requires a few prefiminary remarks, a slight
definition, or description, of the function that is to be
promoted. — Expectoration is very various according to
the sound or diseased condition of the trachea and glottis :
It is pecuhar to the advanced periods of life, expecto-
ration is no more known in childhood than piles. Sen-
sible expectoration is the consequence only of disease, viz?

134

OP EXPECTORATION.

of the glands, wliich lubricate the trachea, being enlarged
by repeated shght inflammations, and so relaxed, and
so irritable, as to throw out not only a sensible secretion,
but a viscid tenacious mucus. In children there is no
sensible expectoration, unless when excited by inflanir
mation and perpetual irritation, as in measles, where a
thin serous rheum is discharged ; or when, from severe
and long-continued hooping-cough, there is secreted a
profusion of thin gelatinous mucus, trailing along the
trachea at every paroxysm of coughing, often purulent j
fi'om inflammation of the trachea. Of this purulent
mucous disc’;arge I have seen many children die, cough-
ing, fretful, sleepless, pining, wasted by the profuse eva-
cuation, and dying hke adults in phthisis.

Expectoration begins to be perceptible from fifteeij
to twenty years of age, and then consists of thick,
starchy-hke mucus, of a bluish tinge, fi’om the smoke
inhaled in the town, and during the winter sea-
son ; and is sensible only in the morning, and in some
habits in the evening. But wfiile the person enjoys
health, it is discharged in small quantity, is easily cough-
ed up, is pure, unmixed, of a greyish colour, attended J
\vith hardly any sensible cough, brought up by the not
unnatural action of clearing the throat. This slight pe-
riodical expectoration of mucus gradually increases in the
progress of life, and is greater in men from their active
habits : Becoming at last very profuse, it assumes the

form of disease, or is at least a painful natural infirmity,
increased by severe weather to that degree, which is
termed the catarrhus senilis, the cough of old age.

Expectoration is still in the middle period of life hard-
ly sensible but in disease. As the mucus which bedews ■
the urethra, is palpable only when increased in gonor-
rhoea, expectoration is never known nor observed, till
the excess of secretion, the cough, and the diflicidt

VARIOUS KINDS OP SECRETIONS.

135

breathing which attends the cough, amount to disease ;
and in disease we perceive many various conditions of
the trachea, and are sensible that expectoration consists
of three distinct secretions. First, The thick ordinary
wholesome starch-like mucus, which is secreted in the
glands, or small follicles of the membrane which lines
the trachea. Second, Of that thin, serous, and acrid
rheum, which distils along the whole Schneiderian sur-
face, from all the exhalent vessels opening upon the
inner surface of the trachea and bronchise, distinct from
the mucous secretion; it is so distinct, that the mucous se-
cretion seems to cease when the serous effusion prevails,
as in a recent cold ; and the mucous secretion becomes
again sensible, when the serous effusion ceases, or in
other terms, when the rheum or cold subsides. Third,
When instead of being inflamed and irritated, the inter-
nal surface of the trachea is in an ulcerated condition, then
the vessels which before distilled a thin serum, secrete a
purulent suppuration, a thick yeUow semi-purulent mu-
cus ; and this thick yellow sputum, is not the secretion
of the inflamed glands, but of the inflamed surface ; for
the clots, or coagula, of gi’ey and tenaceous globular mu-
cus, whose small globules preserve the mould of the
minute sacculi or lacunse, in which they are secreted,
are found involved in the thick yeUow expectoration.

Thus, though the sputum is often mixed and various,
there are four distinct species of expectoration, four dis-
tinct conditions of the tracheal secretion. — First, The
grey globular mucus secreted in the small lacunse, still
retaining the globular form of the individual lacunas,
but expectorated in small masses. — Second, A thick ge-
I latinous but fluid mucus, secreted by the same glands,

' plainly of the same nature, but not retaining the glo-
bular form, inconcoct, glairy, and tenacious, secreted
under an incited action of the arteries, and felt trailing

136

SECRETION VARIED BY DISEASE-

upwards and downwards in the trachea, with each pa^
roxysm of coughing. — Third, The tliin and acrid serum
proceeding from all the exhalents of the inner membrane
of the trachea and bronchiae, from the whole Schneide-
rian surface. — Fourth, The yellow, viscid, semi-purulent,
or muco-purulcnt discharge, from an abraded and ulce*
rated trachea.

Disease alone produces expectoration, and we must
trace the progress of disease, and know how it affects this
secretion, before we can use the various remedies skil-
fully : Diseases of the glottis, trachea, and bronchiae, as-
sume a different aspect in any different period of life.

First, When in a young and healthy person, the
trachea is inflamed, whether in measles, or in cold and co-
ryza ; the whole lining membrane being distended, the
secretion of mucus is entirely interrupted ; the voice is
ringing and clangorous, as if the patient breathed through
a brazen tube ; a thin serum distils from the whole sur-
face of the Schneiderian membrane, occasioning frequent
sneezing while it titillates the nostrOs, and continual dry
ringing cough while it trickles along the trachea ; and as
the inflammation flits from one part of the surface to
another, the sneezing or the cough prevail. This is the
form, and these the symptoms of recent cold in youthful
and healthy constitutions ; an inflammation and serous
exudation, which flits from point to point of the Schnei-
derian membrane, from the nose to the throat, and from
the throat again to the nose, aU in a few hours, passing
occasionally down into the lungs.

Second, When this inflammatory affection of the
trachea is intense, the surface is dry from want of
secretion, and the vascular action is such as to throw
out a thick, firm, tenacious, mucous exudation, as often
happens in the irritable trachea of childi'en ; the voice
becomes peculiarly sonorous; it has a croupy sound.

PROGRESS OF CATARRH.

187

iike the crowing of a cock ; the exudation increases till
the trachea is lined with it, the branches of the trachea
are interrupted, and the child suffocates. This is the
Cynanche Stridula, or Suffocating Cold or Croup.

Third, In a man grown to maturity, the cold or ca-
tarrh assumes a different form, from the mucous follicles
having become enlarged, and expectoration having be-
come a natural function. The trachea has, dmihg the
progress of life, been occasionally inflamed ; the mucus
of the trachea is become habitually profuse ; the rheum
begins with a distillation of serum from the nose, and
sneezing; then the inflammation flitting from surface
to surface, affects the trachea, and a tickling, incessant
cough ensues : the voice is changed by the swelling of
the Schneiderian membrane ; the serum runs now hot
and acrid, like the serum of a blister, along the whole
trachea, exciting incessant tickling cough, without ex-
pectoration or relief. — On the fourth or fifth day, the
serous exudation lessens ; the serous secretion thickens
into a palpable expectoration, a mixed expectoration of
much serum, a proportion of mucus, and a thick and
s purulent matter from the surfaces of the trachea and
bronchia?.

The expectoration now brings relief, because ex-
pectoration begins only when the inflammation de-
clines ; and the mucus being now more tenacious and
consistent, the breath impelled by coughing brings up,
at each paroxysm, a proportion of mucus, which relieves
the trachea and glottis of the irritation. But each re-
newed catarrh relaxes more and more, both the exhalent
arteries, and the lacunje which secrete the mucus ; so
that, in the progress of life, the mucus becomes habitually
profuse, and the membrane habitually irritable, and a
periodical cough is the condition in which the individual
must continue to live, piore or less distressed, according

13S

OF CHRONIC CATARRH.

to the care he takes of his constitution, or the occupa-
tion, climate, and circumstances in which he exists.

- Fourth^ As the mucous secretion becomes more pro-
fuse in consequence of frequent colds, or, in other words,
in consequence of wasteful toil and labour, the cough
increases with the patient’s years : He has, in his most
healthy condition, a frequent expectoration morning i
and evening, an uncleanly cough, — sospe eviungit, as the i
satirist says; his walks, morning and evening, termi-
nate in expectoration, and he needs to observe what
Hamlet calls “ his breathing hour of the day he needs
to regulate his expectoration by exercise, as he would
regulate any other bodily exertion by observances.

He spits up a few masses of the greenish, globulated,
starch-like expectoration, morning and evening, and
feels relief But when affected with cold, when the
, east wind blows, when winter begins, he is affected
with catarrh.

He has, on the first severe attack of the winter;
a cor}"za, a common cold, a serous running from
the nostrils, and tickling cough : then a frequent and
difficult expectoration, of hard masses of globular mu-
cus : His morning and evening coughs are very afflict-
ing, impelling the blood into the head, till the brain
turns round, and the sight fails ; and in tlie second or
third week, the whole trachea is inflamed, the serous
exudation is changed into a purulent mucus, and the
grey and globular mucus is no longer distinguished, for
the lacunee which secrete it are so inflamed and enlarged,
that their secretion is changed into a glairy, gelatinous,
uniform mucus, which trails up and doAvm the trachea
at each paroxysm of coughing, and is expectorated with
great labour.

Tliis is the Chronic Catarrh, the Catarrhus Senilis,
which leads, in the latter period of life, to asthma and , i

OF ASTHMA.

139

dropsy : In the aged, and after the structure of this

glandular apparatus is much affected, the paroxysm has
hardly any intermission during winter ; the whole course
c£ the trachea and bronchiae inflames; the exudation
becomes yellow, thick, purulent, and very tenacious,
so that a rattling or screeching cough accompanies each
effort to expectoration ; the surface of the trachea is
raw and ulcerated ; and after the winter-cough has ex-
pired, and when in spring the ulceration ceases, the
bluish and starchy mucus, the natural secretion of the
follicles, begins to appear again amidst the yeUow and
purulent expectoration, and resumes its wonted regulat-
ed form of a morning and evening cough. It is to be
observed, that while, in each paroxysm of habitual
cough, the efforts drive the blood into the head, and
inject it so that the serum exudes, each fit of mucous or
purulent expectoration is followed by an hour or more
of tickling cough, from the serous exudation which
ensues.

Fijih, Asthma succeeds to chronic catarrh by a pro-
gression too natural, and inevitable. The mucous asth- '
ma, the most frequent asthma, is merely an increase of
the catarrhal disease ; and it is the peculiar disease of
our sad and severe climate. When the mucous disease
of the trachea gradually increases ; — when, instead of
I degenerating, by a more profuse secretion, into a trail-
ing gelatinous expectoration, it is condensed into a firm,
i coagulated mucus ; — when such mucus, instead of being
I moveable, and easily squeezed out from its follicles by
I a moderate contraction of the glottis, and a moderate
I impulse of coughing, requires an accurate and spasmodic
' constriction of the glottis ! then spasmodic contractions
become necessary, and, of course, become frequent. In
! the colds of winter, the mucus is diluted ; but in sum-
' mer, and in warm climates, what should be a cold be-

140

ASTHMATIC PAROXYSM.

comes an asthma, and thus it happens ; In the evening,
the patient seems to himself to have expectorated ; he
has no uneasy feeling to warn him of his danger;
he lays him down to sleep ; perhaps he feels a slight
oppression at the prsecordia, and is conscious of a slight
wheezing in his breathing : In fact, the thickened mucus
is all the while obstructing the glottis, the spasm is insen-
sibly increasing, and at midnight, at two or three in the
morning, he is awakened from sleep gasping for breath,
drawing in the air with a slow, hissing noise, staring about
him with the sense of suffocation, starting from bed, ■
and struggling in great agony. After half an hour or
more of laborious breathing, he begins to cough ; small
particles of firm, compacted mucus, are bolted up ;
much anxiety and incessant coughing follows ; at last
the cougliing forces up the mucus, while a serous exu-
dation, caused by the working of the lungs, dilutes it,
and the paroxysm of asthma is resolved by a profuse
discharge, first of globular, and then of thin and glairy
mucus ; and from six to ten in the morning, he enjoys
a blessed repose after his hour of agony. Yet he awa-
kens exhausted, bathed in sweat, and with an oppressive i
headach and languor. Thus the state of the mucous
secretion, which constitutes chronic catarrh in our cli-
mate, constitutes mucous or chronic asthma in the sum-
mer season, and in warmer countries.

It belongs to another place, to investigate the condi-
tion of the glottis, trachea, and lungs, — to say what is
the express state of those parts, when the glottis, and
caro glandulosa of the rima glottidis, is thickened irre-
coverably into a diseased consistence, with asthmatic
breathing, and hissing noise, as the air passes the glottis !
how the surface is inflamed universally during serous
effusion ! how the glands are relaxed when they pour
out that profusion of glairy mucus, which suffocates

CAUSES OF DIFFICULT EXPECTORATION. 141

with continual trailing cough ! what the condition is of
the membrane of the trachea, when secreting that yel-
low, thick, and purulent mucus, which often terminates
in a sort of mucous phthisis ! But now it is most natu-
ral, and, after this introduction, most easy, to conceive
and define the various causes of difficult expec-
toration ; and when these are correctly enumerated,
the physician knows both how to alleviate those diffi-
culties, and how to calculate upon the condition of his
patient in the morning and in the evening, in stillness
and in exercise.

First, The thin and trickling rheum, or serum, which
distils from all the mucous or Schneiderian membrane, ocv
casions frequent sneezing, perpetual coughing, — but no
expectoration, no relief. There is no viscid nor mucous
secretion upon which the breath, in coughing, can make
impression, nor which can accumulate into a mass, so
as to be coughed out of the glottis ; there is perpetual
cough, but no expectoration. This is the inflammatory
disease which requires bleeding, drastic purges, coolness,
and opiates, to lessen the serous secretion, and abate
the sensibility which occasions the incessant cough. This
form of cough requires also ody and demulcent medi-
cines, to cover the inflamed membrane.

Second, The firm, globular mucus, which besets
the trachea and glottis in those advanced in years,
that grey, tenacious mucus, which constitutes the
morning cough, is expectorated with difficulty, when-
ever, from neglecting the needful exercise, the mu-
cus accumidates ; or when, by hurry and irritation, as
entering upon violent exertions in the morning be-
fore the usual expectoration takes place, the effort to
expectoration is so impetuous, as to excite a temporaiy
spasm ; or, lastly, when, upon some slight accession of

142

VARIOUS KINDS OF COUGH.

cold, the trachea is inflamed, and the morning coiigh
aggravated.

{ In these circumstances, we direct the patient to refrain
from morning exercise or business, and eitlier to con-
tinue at rest, or to walk gently and composedly, till the
expectoration of the mucus accumulated during the night
is completed. We sometimes give anodynes to prevent
irritation, until the mucus is accumulated and ripe for
coughing up. We find the chief difficulty to consist in
the instinctive constriction of the glottis, necessary in
squeezing out the viscid mucus from the lacunae in
which it is secreted, for such constriction of the glottis
is necessary to give effect to the impelled air ; and the
chief distress and harm to the constitution arises from
the impulsion of the blood upon the brain, during such
intense coughing. At each severe paroxysm of cough-
ing, the glottis is spasmodically constricted, the mucus
is gathered together, and forced along the trachea by a
ringing and screeching cough, which seems to split the
head. The patient is left quite exhausted ; each fit of
coughing is felt in the brain, the head aches to distrac-
tion, the nose runs with serous exhalation ; and I have
often seen, by the force of the blood injected into the
head, blood extravasated in the face, especially in the
loose skin of the eye-lids, and under the eye.

Third, A more difficult and painful expectoration
still, is that which is to ensue after the grosser coagula
of grey mucus are bolted out ; for then there begins to
run from the same mucous follicles, and from aU the
inflamed surface, a glairy mucus, which trails upwards
and downwards in the trachea ; and while its irritation, ;
and the necessity of pumping the trachea to admit the !
due proportion of air, excites unceasing cough, the se-
cretion is yet so fluid, and offers so little substance and ,
body to the impulse of the air, that the paroxysms of

ASTHMATIC HYSPNtEA.

148

coughing are intense ; one fit of coughifig follows an-
other so unceasingly, that the eyes grow dim, the head
swims ; the brain is so far affected that the patient
sickens, and sometimes falls down in a fit I very often
see the circle round the eyes green with extravasated
blood, and partial extravasation in the cheeks and eyelids.

This condition affects the brain early in life, and
prepares the way for all the other debilities and in-
firmities of old age. In chronic catarrh, then, the diffi-
culty of expectoration is alternately that of feelings of
suffocation before the gross coagida of mucus are cough-
ed up, and of suffering under the unceasing cough
which clears the lungs of this viscid, trailing mucus.
Sometimes we prevent much of this distress by opiates,
and well-regulated hours of exercise, food, and sleep ;
and when we do hope to accomplish a cure, we usually
begin by emetics and sudorifics.

Fourth, That difficulty of expectoration which brings
on asthma, deserves particular notice. The climates and
seasons most propitious to health, are those which bring
on this peculiar distress ; for the true asthma occurs
chiefly m the smnmer and autumnal season, and in warm
climates. The mucous expectoration has become less
troublesome, is coughed up at regular hours, is tena-
cious and firm, gives opposition to the impulse of the
air in coughing, is expectorated, and the expectoration
brings always perfect ease and confidence. But while
the individual is thus in the enjoyment of unusual
health, and is filling up with blood, he is all at once,
after c walk in a sultry evening of autumn, roused from
sleep, alarmed ! He breathes anxiously, and is all at once
involved in the most distressing condition, suffering a
complete paroxysm of asthma, which is for the time re-
solved by a profuse excretion of mucus, but which is
sure to return. The expectorating cough has not be-

144

OF MUCO-FURULENT COUGH.

gun when he goes to bed ; the torpor of fatigue, heat,
and natural sleep, taking off all irritation, the mucus
accumulates, and in the same proportion the spasm of
the glottis increases ; and when he awakes, it is in ex-
treme terror, with indescribeable anxiety of the prascor-
dia, and a hissing noise in breathing: he sits up, »
struggles as for life, gasps, breathes laboriously, at last i
begins to expectorate, and, by expectoration, the fit j
closes towards morning, when the patient lays himself i
down to a disturbed sleep.

Fifth, The muco-pukulent, or mixed expectoration, j
is that produced by recent cold, combined with chronic ■
cataiTh : It is an expectoration of thick yellow mucus, of a j
saltish or sweetish taste, involving in it globules, or masses
of the thick grey mucus. This kind of expectoration is
not unfrequent, especially among the labouring part of
society, even in the prime of life ; it is attended occa- ^
sionally with all the kinds of difficulty just enumerated :
it takes place chiefly in the morning and evening, is
very profuse, and as the expectoration is tough, tena-
cious, and as if adhering to the surface of the trachea, it ,
is brought up with severe coughing, a screeching noise, |
a sense of suffocation, and a degree of impatience. The
slightest aggravation of the rheumy or inflamed state of i
the trachea, brings on a degree of asthmatic difficulty,
or actual asthma; and the excitement of frequent or i
violent coughing, causes an increased serous exudation, li
with a tickling cough, which continues after the mass j
of mucus and purulent sputum has been expectorated.

We shall be sm'ely better able to select the proper re- )
medies, and to estimate their properties truly, after re- •
fleeting on these various forms of expectoration, and the
various difficulties and disti’esses arising from a diseased
condition of the trachea. There is no part of the ma-
chinery of the human body, nor indeed of the animal

OF PROMOTING EXPECTORATION.

145

body, which sooner gives way, or more certain-
ly hastens on all the other infirmities of old age. —
1st, Expectoration is best promoted by being delayed !
for it will be observed, that the most teazing and dis-
tressing cough is that in which the air, impelled by
coughing, has, from the want of consistence of the mu-
cus, no impulse upon the too serous fluid ; this is best
aided by minute portions of an emetic. — 2d, Expecto-^
ration is next best promoted, by abating the sensibility
of the glottis : for its constriction, the natural degree of
which gives effect to the impelled air, is often so spas-
modic, as to retain the masses of mucus in spite of the
most painful efforts to expel them. This object is best
accomplished by opiates and narcotics. — Sd, Expecto-
ration is facilitated by the inhalation of vapours, which
at once dilute the thickened mucus, and do not increase
the serous exhalation ; but on the contrary, by soothing
' the excited action of the larynx, and by fomenting the
inflamed surfaces of the trachea, abate the action of the
exhalent arteries. — 4<th, Expectoration is promoted by
certain stimulant and strong-smeUing drugs, which are
reputed to have an influence as direct upon the mucous
glands of the trachea, as diuretics have on the kidney.
— 5th, Expectoration is facilitated by mucilaginous and
oily medicines, which lubricate not the glottis, for
there they cannot be admitted, but the surrounding
parts, viz. the root of the glottis, the rima glottidis, and
the throat, a great part in short of that surface, which is
so provided with mucous follicles. — These, then, con-
stitute the natural orders of expectorants.

VOI-. III.

K

146

LIST OF EXPECTORANTS.

EXPECTORANTS.

Ipecacuanha,

Antimonium,

Opium,

Digitalis,

Isf.

^d.

PULVIS IPECACUANH.5:
COMPOSITUS.

CiCUTA,

Camphor,

fid.

INHALATIO VAPORIS, InHALATIO OETHERIS SUL- .

PHURICI, I

AQU.® fee- — FUMI TABACCI,

VENTIS,

— — aceti, Stramonii.

Wi.

SciLLA,

Allium,

AmmoniacUm,

Myrrha,

Assafgetida.

5th.

Gum MIMOSA3 Nilotic^,

GlYCYRRHIZA GLABRA,
LiNI USITATISSIMI SEMEN,

Malva,

Althcea,
Oleum oliv^e.
Amygdalae,
Gelatina,

Cetaceum.

Ipecacuanha. — The use of ipccacuaii 1

as an expectorant is very universal, and I know not but •>
that we may ascribe to it also, all the various properties of
a mechanical help to expectoration. It is, as an anodyne, '
fit to suspend the irritation of coughing ; and as an an-

OF IPECACUANHA AS AN EXPECTORANT. 147

tispasmodic, fit to lessen that constriction of the glottis
by which expectoration is opposed ; and as an emetic, it
aids the expulsion of thickened mucus.

Infants expectorate with the utmost difficulty ; they
suffer less than adults from the action of emetics ;
in the short, snuffling, suffocating cough of children,
we often begin the cure by an emetic of two gi*ains
of ipecacuanha, or a small dose of tartrite of anti-
mony. Children expectorate so little, that it is only
when the trachea is almost closed by inflammatory exu-
dation, as in Cynanche Stridula, that we need to give
expectorants ; and an emetic given in the achme of this
disease, sometimes shakes the coagulum or coat of se-
creted gelatin which lines the trachea, and enables them
to reject it.

As an antispasmodic, ipecacuanha is especially cele-
brated in HOOPING-COUGH ; giving every second day
in the morning, an emetic dose of ipecacuanha, is
I found to have the happiest effect, both in relieving the
I breathing, and in shortening the disease. — ^In asthma
it was in high repute as an antispasmodic ; or rather,

1 there is reason to believe, that it is useful by preserving
a perspirable state of the skin, and an active circulation
on the surface of the body. This was the favourite pre-
I sCription of Aikenside, who gave three grains of pow-
! der of ipecacuan every morning daily, or on alternate
: days, to those afflicted with asthma. But in asthma,

I still more than in intermittent fever, an emetic dose an-
' ticipates and prevents the paroxysm ; it relaxes the
1 glottis by its debilitating effect, and by its mechanical
; operation it bolts out the indurated mucus from the
I glandular follicles, saves the patient from a fit of asthma,
and tlirows him into a profuse perspiration, contributing
to remove the febrile and inflammatory attack which had
perhaps occasioned the asthma.

K 2

148

OF OPIUM AS AN EXPECTORANT.

Lesser doses of an emetic, continued after every such
crisis, suspend the cough ; and for this purpose minute
doses, six or eight grains of the pulvis ipecacuanhae cum
opio, or a grain of ipecaaian, in any absorbent powder,
given morning, mid-day, and evening, often has a re-
markable effect in suspending cough and cuiing it ; in
so niuch, that a fenf grains of Dover’s powder taken fre-
quently during the day, has become a popular remedy.
Small doses of antimonial wine, in any mucilaginous ve-
hicle, conjoined with an opiate, have the same happy
effect.

M, Opium, the uses of which as a stimu-

lant, narcotic, and diaphoretic, are already described, is
given with a difference, when used as an expectorant, i
in which tribe it well deserves a place, as perhaps" the i
most powerful! for by delaying expectoration it pro- i
MOTES it. — Opium is given with this difference, that SI
instead of being exhibited in powder, it is best prescrib- j
ed in a mixture, or linctus, as it is called, combined with
mucilages, oils, spermaceti, and liquorice. Its effects 1
seem indeed to be very various, for it invariably ap- i!
peases the cough and suspends it, by virtue of which I
effect, the thin and serous rheum is so thickened, that I
the air has influence upon it. Opium seems also to I
iiave an intrinsic power of rendering the mucous secretion |r
more viscid, perhaps by the same virtue which enables I
opium to suspend all other secretions : it lessens at the 1
same time, that irritability and spasm which at once i
renders the breathing difficult, and the expectoration )
imperfect.

Severe cough seems to be a compound disorder, vio-
lent in proportion to the thinness of the rheum, the ir-
ritability of the glottis, the viscidity of the mucus, and
the degiee of spasm which is sometimes excited by that
viscidity of the mucus, and sometimes by intensity and

OF DIGITALIS AND CICUTA.

149

frequency of the cough ; for if intense coughing be ex-
cited, and continued, whatever be the cause, whether a
drop of water, or a soKd substance as a fruit-stone en-
tering the glottis, the glottis is felt sensibly closing more
and more, with every renewed convulsion of coughing,
till the constriction amounts at last to actual suffocation.
All these causes of severe cough, and difficult, bec*ause
hurried expectoration, opium is suited to alleviate at no
greater expence than a headache, often less intolerable
than that which the cough, if permitted to continue,
would have produced.

Opium, as an expectorant, when given pure, is best
administered in a mucilaginous mixture by day, and a
draught at night. The form of such a julep is varied,
and the virtues of it improved, by combinations with vi-
negar of squills, camphor, balsam of Tolu, &c.

The use of digitalis, in form of tincture, exhibited
in draughts or in juleps, conveying fifteen drops or
more every three or four hours, is appropriated more
to those disorders of the lungs, where vomica or scrophu-
lous abscess is suspected ; when the pulse is feeble and
rapid, with hectic flushings ; in consumption, or in that
muco-purulent expectoration, which so often terminates
in phthisis ; and especially when our chief purpose 'is,
to abate the frequency of pulse, and the pain in the side
or breast, with which phthisis is accompanied.

The use of cicuta is limited, (being a medicine we
I do not choose to use on familiar occasions), to those ma-
I nifestly spasmodic coughs, where, as sometimes happens,
an adult is seized with a disorder resembling the hoop-
ing-cough, viz. a loud, clangorous, intense cough, re-
turning in paroxysms, and each paroxysm terminating
in a suffocating struggle.— Or it is used in genuine per-
tussis or hooping-cough, in children, which, when intense
and dangerous, is sometimes stopped at the moment when

150

INHALATION OF VAPQUK.

the child’s life is manifestly endangered, by giving cicuta i
in gradually augmented doses. i

Cicuta is stiU more particularly the medicine of our )
choice, in that sad condition of the glottis, which we |
often witness in coarse and vigorous men, farmers, horse- i
jockies, fox-huntfers, and sea-faring men : — Being con- ^
timially exposed, and always neglecting their colds, they
first perceive the disease of the glottis begin by a huski- ^
ness of voice ; they next lose the voice altogether, which |
degenerates into a whisper ; next, they feel frequent op- ^
pression, and asthmatic difficulty of breathing, from the i
increasing disorder of the mucous membrane of the I
glottis ; and finally, die of asthma, the glottis and caro
glandulosa being thickened to the consistence of leather.

— In such disease, along with frequent blisters or issues by
the sides of the tliroat, a course of Cicuta, combined with
calomel, is our only recourse, often an unavailing one.

The use of camphor, as an expectorant, is very familiar | ^
in sofe throats, hoarseness, and cold, and it is adminis- j i
tered in the form of draughts, or of linctus, as a sort of i|||
emulsion, with syrups, balsam of Tolu, nitre, or squills. J *

3d, Inhalatio, Vaporis Aquse Ferventis, i*

Fumi Aceti, Vaporis (Etheris Sulphurici, Fumi Nico- (!*
tian«, vel Stramonii. In recent and severe colds, with I '
a thin serous rheum, and great imtability of the trachea ; i
in hoarseness, or the inflamed and thickened condition of I
the glottis, no remedy is more successful, than the inha- I
lation of the fumes of the warm water, which the patient I
may draw through IMudge’s inhaler, or from the stroup «
of a tea-pot, filled very sparingly with boiling water ; the ■
body of the tea-pot, on account of its heat, being wrapped
in flannel. — Though we speak of demulcents, and pre-
scribe oils and mucilages for this pm'pose, there is in :
truth no true demulcent, except the steam of warm wa- '
tpr, for that pervades the whole mtemal surfaces of thp.

OF CETHEB, AND OF STRAMONIUM.

151

lungs and trachea, foments and soothes them by the
heat and moisture, and repeated morning, mid-day, and
evening, has often very happy effects.

Vinegar, used with the same intention,

gives a pleasant pungency, sharpness, and sort of light-
ness to the inhalation, and operates as a gentle astrin-
gent, suppressing the immoderate exhalation.

— (Ether sulphuricus, is used with the

happiest effects, not in the same diseases of raucedo, and
recent cold, but in spasmodic and asthmatic disorders.
But as it evaporates rapidly in open air, no heat is re-
quired for the operation now to be described. A few
tea-spoonfuls of oether are poured into a tea-cup,
which is held close to the mouth, so that the patient,
in breathing, inhales hardly any thing except the va-
pour. If used for continued difficulty of breathing,
this quantity may be poured out, and inhaled three or
four times a-day; if with the hopes of preventing a
paroxysm of asthma, it should be reserved for night.

The inhalation of oether has a slight effect upon the
spirits, or, in other words, upon the nervous system ;
but the fumes of tobacco, to those unaccustomed with
it, produce all the effects of an overpoAvering narcotic ;
first, giddiness like intoxication, and then sickness,
which effectually relaxes the spasm : Smoking a pipe
of the prepared stramonium, produces those effects
on all kinds of persons, Avhether accustomed or not to
narcotics. Yet it must be acknowledged, that in con-
firmed asthma aU those resources fail, and those who
have been most miraculously relieved at first by smok-
ing tlie stramonium, have soon abandoned it.

Mil, Squills, ammoniacum, myrrha,

and ASSAFCETiDA, may be classed under one term of
the Warmer Expectorants, the only ones indeed which
can be supposed to operate directly or specifically upon

152

OF SQUILLS AND AMMONIACUM.

the secreting surfaces of the trachea and lungs ; and from
their qualities it may easily be imagined, that these must
constitute the basis of our pectoral pills, our everlasting
prescriptions for incurable defluxions and chronic ca-
tarrhs ; while the sickening and sedative medicines, the
emetics and opiates, are more fitted to suspend the in-
tensity of active and recent diseases.

The diuretic power of squills we have already men-
tioned ; it is a harsh medicine in taste and in quali-
ties, whether as an emetic or as an expectorant. The
dried squill, rubbed down with sugar and camphor,
is prescribed as an expectorant, in moderate doses of two
or three grains foiur times a-day, followed by opiates
at night: a form of prescription esteemed especially
useful in the aggravated state of chronic catarrh. When
conjoined with camphor or ammoniacum, in form of pills,
they should always be of a soft consistence : Though i
■ the pilulcB sciUiticae of the pharmacopoeias be an excel- t
lent prescription, yet becoming hard, they become in-
effectual : they should be recently prepared.

The VINEGAR OF SQUILLS, in which the extreme
acrid bitter of the squills is combined with intense aci-
dity, is a very forbidding medicine, and fitter to exhibit ;
the emetic than the expectorant power of squills ; yet it 1

is often prescribed, and especially to children. It is ^

often added to pectoral juleps, and mucilaginous mix-
tures.

Ammoniacum, of a yellow colour, and

nauseous, sweetish-bitter taste, is a green resin brought
us from the East Indies, and highly reputed half a cen- >
tury ago, as a pectoral medicine. — Like most stimulant
drugs, it affects the bowels gently, and promotes per-
spiration, urine, and all the secretions, when given in a
full dose. It is used also in chlorotic amenorrhoea, as
in catarrh.— I have not been ab^ to perceive, that its

GARLIC AND ASSAFOSTIDA.

15^

effects as an expectorant are such, as to compensate for
its thick and turbid appearance, and nauseous taste,
when given in the form of a pectoral mixture ; If used,
it should be in pills, which, to produce any effect, must
be of no very moderate size, nor given very sparingly.

— Myrrh, the Gum Resin, flows from a

tree as yet unknown, growing in Upper Egypt, and in
the East Indies. It is a strong, aromatic, bitter gum,
of a reddish yellow colour, and a strong and peculiar
odour. Its properties of stimulating and promoting
every secretion, especially the menstrual, are nearly the
same with those of gum, myrrh, ammoniacum, balsams,
as of Tolu, Capaiba, &c. : Turpentines, have all the

same general influence in stimulating gently the gene-
ral system, and promoting all the secretions. Myrrh,
as an expectorant, is sometimes given in powder, oflener
in piUs, conjoined wdth ammoniacum.

Allium sativum. Garlic the root, is, I

sincerely believe, the most valuable of those stimulant
expectorants. It has the same pungent smell, and acri-
monious taste, the same diuretic and sudorific qualities,
as the squill, and is preferable to it as an expectorant in
chronic diseases, when a hot and acrimonious stimulant
may be prescribed. It is less properly a pharmaceutic
prescription, than a domestic medicine : For relief of
breathing, and for promoting expectoration in asthma,
and asthmatic coughs, it is best given in substance, the
patient swallowing one or two cloves at going to bed,
or a few transverse slices. Onions are often eaten at
supper, Avith the same intention, and indeed with the
same effect. In chronic catarrh, a decoction of garlic in
milk, given to the amount of a pint morning and even-
ing, is said to be of great service.

Ferula assafcetida is imported from

the Levant : it is the exudation from the root of a plant,

I

154* DEMULCENTS.

obtained by laying the root in part naked, cutting it
across, and scraping off the gum-resin as it exudes. It
has a bitter, acrid taste, and an overpowering smell, re-
sembling that of garlic, but peculiarly and prover-
bially offensive. It ranks with garlic, onion, myrrh,
and the other stimulant resinous drugs, as an expec-
torant, suited chiefly to the catarrhus senilis ; but with
a taste and smell so repulsive, that few can overcome
their reluctance to this drug. Though i^sed in hysteria,
especially in form of glyster, in amenorrhoea, and in
dyspepsia, its chief value is as an expectorant. It is
prescribed in powder along with myrrh, or aloes, to the
amount of a scruple, or half a drachm, three or four
times a-day; or still more commonly in pills, or to
those who can take it so, in mixture,

5th, De]mulcents are so named, from a suppos-

ed virtue of lubricating the internal surfaces; but of these
surfaces, I know of none that are accessible! Those
of the glottis and larynx certainly are not so, for the
smallest particle, even of water, admitted within the
glottis, excites suffocating spasms! That of the tra-
chea is stiU less so. I know of no surfaces, then, that
can be lubricated, except that which surrounds the
glottis, and the surface of the pharynx ; and how far
the lubrication of that surface may, by giving smooth,
unctuous, and pleasant feelings, lessen irritation, it is
impossible to say ; certainly demulcents do somewhat
affect the feeling of the whole surface, and lessen the
tone of hoarseness, and the sense of rawness. But the
medicines I am now to enumerate, seem to me so little
important, that I hardly can regard them in any other
light than as vehicles. Of their various uses in nephri-
tis, dysentery, gonorrhoea, diseases of bladder, &c. I do
not mean to speak, but only of their use in coughs, and
diseases of the trachea.

LIQUORICE. — LINT-SEED. — MALLOWS. 165

Gum mimosa nilotica, Gum AraWc,

IS that which, on account of its solubility in water, and
its bland, sweet, pleasant, mucilaginous taste, supersedes
all others. It is much used for aiding the mixture of
oils with water, in all extemporaneous prescriptions;
and its mucilage, with little fiirther aid than a slight
tinge of balsam of Tolu, or the addition of a small
proportion of laudanum, serves as a pleasant medicine
in coughs and colds, and may be administered without
restraint.

Glycyrrhiza glabra. Radix, Extrac-

tum ; the Extract of Liquorice, prepared by decoction,
and inspissation from the roots, is a sweet, mucilaginous
juice, in which are naturally combined the two prin-
ciples most useful in catarrh, viz. the Saccharine and
Mucilaginous. It is, especially when compounded with
a slight addition of opium, as in the prepared liquorice
of the shops, a very useful medicine, and pleasant. Its
other uses as a vehicle for bark, &c. we have no occasion
now to speak of.

Lini usitatissimi semen, the Seed of

the common Flax, is stiU more valuable ; for, though
inoffensive, (unless it were offensive by being insipid), it
contains combined the vegetable oil and mucilage, in
nearly equal proportions, and is, next to mucilage of
Gum Arabic, very useful. An infusion of lint-seed is
the usual domestic medicine in the cure, or alleviation
at least, of colds and hoarseness ; it is the demulcent,
also, most resorted to in nephritis, gonorrhoea, &c. It
is more a domestic medicine than a prescription.

The uses of the common mallow, Malvae Folia, of
Flores Althe2e, marsh-mallow, of olive almond-
oil, and of spermaceti, are so familiar, that it were a
very waste of time to detail their natural history, che-
Diical properties, or uses in medicine, By the help of

156

OF EMMENAGOGUES.

mucilage, or of sugar, they are made to mix with the
distilled waters, in compounding pleasant draughts, and.
linctuses for cough : but it is sufficient that various
specimens of this placebo kind of prescription are given
among the extemporaneous receipts.

Emmenagogues.

Were we to enumerate, under this head, such indivi-
dual remedies only, as influence the menstrual discharge
immediately and distinctly, as nitre provokes urine, or
opium perspiration, our catalogue would be scanty in-
deed. The term Emmenagogue implies, and the world
believes, that we are possessed of specifics, which will
at any time, and in all circumstances, excite menstrua-
tion, or procure abortion : But we arrogate no such
power ; we know of no such medicines ; we cannot pro-
cure abortion, (and abortion is more easily procured even
than menstruation), without using stimulant drugs of
such irritating quality, that they operate rather like
poison, by exciting the bowels, and are as apt to occa-
sion death, as to procure miscarriage : Few attempt the
crime of procuring abortion, without danger of commit-
ting murder. When we come to enumerate the virtues
of those medicines which we are most inclined to trust
to, we dare say no more than this, even of the most
powerful, “ It is a medicine reputed powerful in pro-
moting menstruation.”

It is more by a combination of effects, than by any
specific medicine, that menstruation, when defective, is
to be promoted or restored. It is rather by conceiving
just ideas of the nature of this function of the womb,
of its dependence on the general condition of the sys-
tem, and of the peculiar constitution of our patient.

or THE MENSTRUAL CONDITION.

157

that we are to prevail, than by the power of any indi-
vidual drug. It may be right to ^ve a catalogue, and
character, of such medicines as are reputed Emmena-
gogue, though that would be brief indeed ; but it is of
far higher importance, to give a general conception,
however slight, of the causes of suppression of the
menses, and the condition of the system.

There is no other periodical secretion but menstrua-
tion ; and its purpose is sufficiently important to account
for so singular a provision. It is destined to preserve
that fruitful condition of the womb, which does not be-
gin till the period of menstruation or of puberty, which
ceases before fifty years of age, when menstruation
ceases, and which is suspended during the period (rf*
suckling, because menstruation is then suspended. In-
terruption of the usual flow of the menses is injurious
' to the fruitflil condition of the womb, as well as to ge-
neral health : but whether the injury to the health of
the individual arises from the inactive state of the ute-
rine system, or is the cause of that inactivity, is a pro-
blem to be resolved only by a general review of the
phenomena of menstruation ; and this is a practical
question of no small importance.

It is generally believed, as indeed all ordinary ex-
pressions imply, that the interruption of menstruation
injures the health; but this proceeds from not dis-
tinguishing rightly the menstrual condition of the
system, from the menstrual flux, which is but a con-
sequence. The MENSTRUAL CONDITION, — the gene-

ral action of the vascular system, by which it is pre-
pared for menstruation, is marked by a sense of increas-
ing fulness of blood, a hysterica! anxiety of the prae-
cordia, and difficulty of breathing; by giddiness and
confusion of head, irritability of the whole frame, ner-
vous and hysterical affections, headach, pains of the

158 SIGNS OP THE 3IENSTRUAL CONDITION.

loins, and an incited pulse: the breasts swell, tli^
veins become tumid, the breathing quick and hurried :
all preternatural tumours are increased in size : varicose
tumours burst and bleed : and if menstruation, which
relieves all those symptoms, be delayed, blood bursts
from the various surfaces, as the stomach, the lungs, or
even the pores of the skin : such is the degree of uni-*
versal vascular excitement which precedes menstrua-
tion.

This menstrual condition of the female system, pre-
cedes the actual flow of the menses, and prepares the
uterine system for the change : It is a period not of ima-»
ginary delicacy, but of unquestionable and very peculiar
irritability: The strongest constitutions are somewhat
affected, and the delicate are quite overeome ; the whole
system is so susceptible, that ordinary causes have very
painful effects ; whatever disturbs the stomach, or fa-
tigues the body, or affects the mind, has at that time
particular influence : Cold, fatigue, terror, grief, or anger,
in short, any sedative power, is apt to suspend this
active condition of the arterial system, and prevent the
approaching discharge, or stop menstruation while it
flows ; and often, by preventing the uterine system as-
suming this necessary action, such causes occasion im-
perfect menstruation, and ruin the health.

The MENSTRUAL CONDITION, then, as distinguished
from actual menstruation, or the actual uterine secre-
tion, is “ an incited, active, haemorrhagic condition of
the whole vascular system, which exists before the dis-
charge flows, and which is equally relieved by the ute-
rine secretion, or by any vicaiious haemorrhagy, and
which spontaneously ceases, whether menstruation fol-
lows or not.”

When menstruation fails to appear, or is imperfect,
it is either from want of this general haemorrhagic ac-

OP AMEN0RRH(EA ANl) DYSMENORIIHCEA. 159

tion, or from want of corresponding action in the uterine
vessels : these are the two points which the physician
has chiefly to observe. The general and the local actions
have a mutual dependence on each other ; and I doubt
not, that the general action, or menstrual condition,
arises, in some degree, from the excitement in the ute-
rine system beginning to be felt at that time, when the
uterine system becomes perfect, and the breasts are un-
folded,—just as the vigorous and manly condition of the
male, and the change of voice, follow the secretion of
the semen, and the unfolding of the genital parts. But
the general action is more important than even the local
excitement ; this at least is sure, that the want of gene-
ral action, from want of vigour in the female system, is
the more frequent cause of disordered health.

When the health of a girl approaching to puberty
proceeds uninterruptedly, and to the natural tone of
vigour is added this new excitement from the uterine
system, the whole frame undergoes a gradual and fa-
vourable change, in the animation and expression of
countenance, in the fulness of the person, in its more
perfect proportions, and still increasing vigour and sym-
metry. But when, in a delicate frame, not endowed
with sufficient susceptibility or strength to sustain this
new action, the menstrual period arrives without an
effectual effort ; — when, instead of this menstrual con-
dition, only a slight degree of irritability and vascular
action is perceived ; — ^when, instead of becoming more
florid, active, vigorous, and healthful, the girl becomes
slothful, languid, unapt for exercise, feeble, with swell-
ing of the ankles, want of appetite, and a yeUow tinge
of the skin, — the disease, which the French, ever more
attentive to such complaints than we are, have agreed
to term les jaunes, the yeixow disease, the chlo-
rosis, is established.

16a

AMENORRIKEA.

There are two principal forms of this disease, viz.
1^/, AMENORRHOEA, or DYSMENORRHCEA, Delay of Men-
sti'uation, or, as it may be termed. Retention of Men-
stiiiation, and Difficulty of Menstruation : These are the
various forms of the disease peculiar to the age of puberty,
to delicate girls of languid habits, or weakly constitutions,

and frequent in the higher ranks of life : and, M, sup-

PRESSio MENSiUM, or the sudden, and we may say, vio-
lent Suppression of the Menstrual Discharge, just when
it is about to flow, or while it actually flows. This is
an acute disorder, to which women of strong and san-
guine constitutions are more exposed, and which is
more frequent with women in the lower and labouring
classes of society. When we arrange the individual
emmenagogues, we must order them so, as to appro-
priate them to one or other of these classes.

Amenorrhcea, defect of menstruation, the menses
failing to flow at the period appointed by nature,
and marked by the particular feelings of oppression,
anxiety, drowsiness, headach, restlessness, irritability,
and sickness, is a disease of weakness. The habit and
appearance of the girl prove it. The usual tokens of
this clilorotic disease are, — a pale or yellow complexion,
a feeble, depraved appetite, difficult breathing, a sickly
languor, an imperfect menstruation flowing sparingly,
just appearing, then ceasing ; continuing not two days,
returning at interv^als of two or three months, not en-
tirely established even eighteen months after it has be-
gun ; all the intervals being occupied by sickly languors,
listlessness, breathlessness, headachs, and sickness.

This state of the system, which threatens to entail
continued ill health, arises from the want of the men-
strual condition, of the fuU, active, and hsemorrhagic
state of the system. It is a kind of debility which be-
comes daily more and more confinned, the consequence;^

OF SUPPRESSION OF THE MENSES.

161

viz. the languor and sickliness, still augmenting the
cause. To this state of menstruation are appropriated
all the stimulant medicines which have been esteemed
.specifically emmenagogue, all which either excite the
uterine system, or irritate the adjacent and consenting
parts, as Savine, Madder, Myrrh, Iron, Hellebore, A-
loes, and Cantharides : — We never neglect to use also
those more familiar stimulants, which best support the
strength of the system, and the vigour of its secretions,
as air, exercise, riding, dancing, the cold bath, and fer-
ruginous mineral waters ; many of which are equally
fitted for supporting the general strength, and exciting
the uterine action.

SuppRESSio MENSIUM is the term applied to that sud-
den, and we may say violent suppression of the menses,
which arises from causes quite different from debility,
and which occurs more frequently in habits every way the
reverse of that just described, ^fiz. from the hysteric ha-
bit. Languors, faintings, and hysterical suffocations, are
frequent, no doubt, in the languid and chlorotic female ;
yet the true hysteria, the violent paroxysm, the suffo-
cation, grasping of the throat, clenching of the hands,
and writhing of the body ! the hysterical sobbing and
cries ! the delirium, and temporary hysterical mania, are
peculiar to strong, fuU, sanguine, and passionate women,
especially of the lower ranks of life.

Both from the habits in which sudden suppression of
the menses occurs, and from the causes, and also from
the cure, I am inclined to regard this as one example of
the general fact which I have stated, \fiz. that, during
the most intense arterial action, all the secretions, and
this among others, is suddenly suppressed. — In strong
and athletic women of the lower ranks of life, menstrua-
tion is often suddenly aiTested by passion and emotion,
by cold, or by violenrlabour : and straiglitway ensue

VOL. III. E

162

OP SPASM OF THE VESSELS.

colicky feelings, disorder of the whole systera,i and
violent hysterical paroxysm of sobbing, alternate fits
of laughter and crying, suffocating struggles, and vio-
lent hysterical paroxysms. This sudden suppression
is not brought on by grief and distress in the feeble
and sickly, but by anger and passion in the sturdy
and athletic: for example, by cold suddenly applied,
while the system is heated; — ^by washing the steps
of the stair; — or by the labours of the laundry or
the dairy. — Those are the habits* those the causes, of
sudden suppression of tlie menses ;• the most approv-
ed medicines are, bleeding, gentle opiates, pediluviae,
and tepid baths ; and the topical application of steam,
or stupes, and quietness, and peace of mind, administer
to the cure. These are not the habits, nor this the
forai of the disease that requires stimulants, cold bath-
ing, or mineral waters, in the interval of menstruation ;
but, on the contrary, a composed, indolent life, with
the frequent use of baths to relax the system, and the
repetition of opiates when the period of menstruation
approaches.

We are told that there is, in such cases, a spasm on the
uterine vessels : What is spasm ? An undefined and ar-
bitrary term : So little are we warranted in using it on
this, or almost any occasion, that we know no more of that
condition of the uterine exhalent vessels, which prevents
menstruation from flowing, than we do of that state of
the emulgent vessels, which prevents the secretion of
urine ; and are no more entitled to say there is “ a
spasm of the exhalent vessels of the uterus,” than that
there is a spasm of the descending aorta, such as to pre-
vent blood descending to these said extreme vessels. By
SPAS3I, then, of the uterine vessels, pathologists mean
no more than this, that there is some condition of the

AEUaNGEMENT of EMMENAGOGUEfi.

163

ilterine surface unfavourable tb menstruation, which
anodynes, and tepid fomentations, tend to relieve.

The use, then, of Emmenagogues, and the classhd-
cation of them, is extremely simple In amenor-

RH(EA, or DYSMENORRHGEA, we have first to" improve
the strength, to nourish the constitution, and to pre-
scribe such medicines as excite habitually all the se-
cretions; and, at the return of that period when ap-
proaching mensti'uation is announced by pains and dis-
tress, to make a particular impulse by imtating purges :
2c/, In suppRESSio MENSiUM, to lower the tone of the
whole system, to bleed the athletic and \dolently hyste-
rical, to soothe the system with tepid baths and opiates,
and to prepare for each menstrual period, by baths,
opiates, and slightly stimulating purges, which, by ope-
rating on the rectum, are the only true emmenagogues.

I proceed, then, to enumerate the few remedies, or
the tew methods rather, that we are possessed of, for
promoting the menstrual discharge ; which comprehend
not only the means of preserving the fmitful condition
of the system} but of improving health, of which a
justly-regulated menstrual discharge is the sign, and not
the cause. But let me remark, that the methods and
processes we use, though not specially emmenagogue,
(a quackery against which I protest), are yet of most
j powerful influence, exactly because they ar^ not medi-
. ^ cines, but natural excitements and supports of vascu-
I lar action : and we are every day conscious, that there
i are no circumstances in which the advice of a prudent
I physician, even though he prescribe no drugs, is so cri-
tical and important, as in those disorders.

164.

DANGEROUS EFFECTS OF SAVINE.

Emmenagogues.

JUNIPERUS SABINA,
Lytta,

Rubia TINCTORUM,
Myrrh A,

Ferrum,

Aloes,

Hellebores Niger,

Hydrargyrum,

Opium,

Electricitas,
Aura galvanica.
Balneum calidum,

InJECTIO AQUtE te-

pida: vel lactis,
Equitatio,
Saltatio,

Balneum frigidum,
ViNUM,

Therms.

Sabina, juniperus sabina, Savine. The .

leaves of this plant, which grows spontaneously in Tar- ;
tary and Siberia, have a strong animal smell, a taste jj
extremely acrid, and, when dried and applied in the
form of powder for extirpating warts, or reducing fungi,
are so extremely irritating, that we dare hardly use the i
medicine, even for those coarse purposes of external ap- , ]
plication. It may Avell be judged dangerous to use such ,tii
a medicine internally ; and, indeed, those who, in their ^ f
ignorance of its powers, have thought very simply to i
procure abortion without any danger, have found them- i
selves involved in a greater crime. Savine procures i
abortion, as any other poison would, by its extreme i
acrimony ; for the effect of a large dose, two drachms 1 1
for example, is, that the bowels are tortured, blood be- |
gins to flow by stool, the straining affects the uterine i r
system, and a bearing down comes on, with flooding, i i
labour pains, and increasing diarrhoea ; tlie unhap-
py victim of the experiment miscarries on the second
or third day, and, being exhausted by diaiThoca and loss
of blood, falls into fainting-fits, continual hiccup ensues.

OF RUBIA TINCTORUM.

165

with pallid countenance, and cold extremities, and she
dies : Yet, if there be a true emmenagogue, it is this.

The fresh leaves of savine are infinitely less acrimo-
nious than the pulvis sabinas ; a conserve of the fresh
leaves may be safely given in two scruple doses, the
dried powder in smaller proportions, combined with
myrrh, with carbonate of iron, or with aromatics. But
this is a dangerous medicine stiU, nor dare we say much
in behalf of that which is next named, viz.

The LYTTA, the meloe vesicatoria, or

Spanish Fly, whose diuretic and stimulant qualities, and
whose dangerous effects on the bowels, have been al-
ready described. The irritation it occasions within the
pelvis, whether from the rectum or the urinary bladder,
j affects the uterine system ; and the stimulant power of
the cantharides, when they produce strangury, or tend to
! do so, cannot but have some influence. I have been
I much accustomed to prescribe the Tinctura Lyttas in
such disorders, (and more freely in females when the
j urinary passages are less complicated), combining it al-
ways with the tincture of hellebore, and giving it in
doses of half a drachm, increased to a drachm or a
drachm and a half, daily.

j Rubia tinctorum. Madder, can by no

means rank with these distinguished stimulants, and yet
is esteemed the purest emmenagogue of aU, for no other
I reason that I can divine, but its beings destitute of al-

i most aU sensible properties, and having no other ima-

! ginable qualities. If, indeed, madder be a powerful

j emmenagogue, it is a wonderful one ; it is prescribed

i by Dr Home, our late Professor, in doses of half a

[ drachm, three or four times a-day : I have both doubled

! the dose, and given it more fi-equently, but without

I any sensible effect. It is, in my poor opinion, a useless

' load to the stomach, and by no means an ornament to

166

MYRRH. — IRON. — ■ALOEb’.

the pharmacopoeia, but fitter for the dyer’s vat. It is
from no passion for saying quaint tilings, that I allow
myself to speak ivith seeming levity, but from expe-
rience, and repeated disappointments. That madder
tinges the urine, the perspiration, and even the bones,
is true ; but that such property of colouring the secre-
tions infers extraordinary powers, is a very vulgar error.

Myrrh A, Gum Myrrh, is more effec-
tual as an emmenagogue, than as ai\ expectorant ; its
quaUties of waraiing the stomach, and exciting the sys- •
tern, ‘and promoting aU the secretions, ensures it a place
among those remedies by which we seek to correct a .
cold, sluggish, chlorotic habit.

Ferrum, Iron, the best reputed tonic,

and general stimulant, the medicine most particular-
ly interdicted in liEemorrhagic and inflammatory dis-
. eases, is assuredly the best suited to the chlorotic consti- t
tution of a weakly girl as yet unconfirmed in health, and 1
especially unconfirmed in that function, which is in wo-
men the very testof health. — Thecarbonate of iron, the sul-
phate, the acidulated tincture of iron, are all promiscu-
ously prescribed in this disorder; and the carbonate is ;
often combined with myrrh in pills and powders, for
promoting the flow of the menses. But the more pow- j
erful medicines, for making an immediate impulse on |
the uterine system, and exciting its vascular action, are *
the Resinous purges, especially aloes.

Aloes, hitherto mentioned chiefly as a j.

laxative, or cathartic, is found almost specific in procur-
ing a flow of the menses : Even when used as a cathartic,
its chief effect is upon the extremity of the rectum ; it
irritates the part, produces tenesmus, excites piles, stimu-
lates the bladder, and promotes menstruation. — When^
by every token of the preceding heaviness, and increas»
mg pains in the loins, we know that menstruation is ap-?

OF MELAMPODIUM.

167

•proaching ; when the menstrual condition has been ris-
ing towards its achme for some days, but the uterine
vessels have not seconded this general action ; then, by
bathing the feet, and giving an opiate at night, and
adding a drastic dose of aloes in the morning, menstrua-
tion often begins to flow, chiefly during the quietness
of the succeeding night ; and though the show, as it is
named, or first appearance of menstruation, be but slight,
the repeating this process, at one or two periodical terms,
completes the cure.

The Tinctura Aloes Composita, or combination of aloes
with saffi-on and myrrh, used in smaller doses, and as a
stomachic to invigorate and excite the system, has con-
spicuous effects in chlorotic constitutions.

Helleborus NIGER, Melampodium, Black

Hellebore, is an old and much neglected medicine, of
great intrinsic power, not as a purge, in which sense I
never have used it, but as a warm and stimulant medi-
cine, such as aloes is, and like it, peculiarly appropriated
to the lang-uid and chlorotic constitution. It is not, like
the Veratrum or white hellebore, an acrid burning poi-
son, yet is used as if it were, doubtfully and timidly.
The celebrated Dr Mead found this one of the most ef-
ficacious emmenagogues : there is no medicine of whose
virtues I am so little doubtful ; it may be given morning
and evening, a tea-spoonful for a dose, in a glass of
warm water, increasing the dose gradually till it pro-
duces its effects. Nor is hellebore a medicine to be re-
served entirely, like aloes, for the critical moment in
W'hich menstruation is expected to show itself I often
give it in combination with tinctura lyttse.

Hydrargyrum, mercury, is less fre-
quently resorted to as an emmenagogue than it should
be ; and the reason is plain, we use mercury in no disease
with sufficient confidence, except in lues. The barba*

1

168 OF THE USE OF MERCURY.

rous practice of severe salivation in every case caused it
to be abandoned, and to this barbarous and ill-regulated
use of mercury, more befitting the usual proceedings of .
Paracelsus, or Van Hehnont, than of rational physicians,
succeeded that pitiful inefficient practice of giving what
is called an alterative comse, viz. slightly affecting
the gums, and keeping them slightly affected, fiom
which, I can too surely affirm, very many have uretriev- -
ably lost their health. No sooner was this distinction |
established, than it became also an established rule of |
practice ; that for all other diseases except lues, altera- e
tive methods only were requmed. Daily we deceive our- f
selves with this word Alterative ! We imagine, we be- .
lieve, that we are altering, only because we are not sen- •
sibly affecting our patient’s habit. Mercury, to be use- -
ful, must have physical effects, and these must be sen- ►
sible : to be conspicuously useful, it must be made to Iji
operate powerfully : To cure suppression of the menses, |
(for amenorrhcea it is the reverse of useftil), mercury i|
must be so given, as strongly to affect the mouth ; and |
having affected the mouth for some space of time, the [ij
patient begins to recover her strength ; and the return ]i
of the menses, which often happens, will be more than ,
a compensation for the alarms the patient has felt, at !
using a medicine which the female sex are accustomed i
to dread more than any disease. Some have been ac-
customed to use the blue pill, which I do not quarrel
with, but rather prefer tfie submurias hydrargyri, in
doses of two gi’ains, repeated three or four times a-r i
dav.

Those are perhaps all the principal remedies that wc
ought to name, — all surely that we need to use as
emrnenagogues : one only remains to be mentioned,
OPIUM ! — What process of the medical art, what cure is
there, in which this invaluable medicine does not hold a

■ r

OF BATHS..

169

place, as an auxiliary at least, if not as a principal means
of cure? Opium, given at bed-time, whatever stimu-
lant medicines are used during the day, prepares the
uterine surface for the menstrual discharge; and in almost
all our processes of cure, an anodyne is given at night.

The other means inscribed in the list, though not pe*
culiarly emmenagogue, are yet most essentially useful
in co-operating ivith those we have named, as proper to
be prescribed during the menstrual condition or orgasm.
The TEPID BATH is eminently useful ; or pediluvi.®
every night at going to bed, which almost supersede
the warm bath ; or hot fomentations, covering all the
pelvis and private parts ; and what is far too much ne-
glected, the direct injection into the vagina of warm wa-
ter or milk.

Those are the means which complete the whole pro-
cess of cure, and assist the operation of the anodynes
and emmenagogues. They are resumed at each re-
turning period, but all the interval is occupied with the
use of whatever may invigorate the system, unless
where mercury is given, — Riding, walking, dancing,
the moderate use of wine, cold bathing, and mine-
ral waters of the Chalybeate kind.

Class VII.

of stijMUlants, and of rubefacients or exter-
nal stimulants.

However conspicuous various remedies hitherto de-
scribed may be for their stimulant power, some exciting
the nerves, others the organs of secretion, still it is na-
tural to set apart in one class, the remedies which have
no other distinguishing quality, which, merely stimulate
and excite. — Garlic, squills, cantharides, stimulate; Every

170

OP stimulants as placebos. •

emetic,’ and every cathartic, and every sudorific, stimu*
lates : but these are not remedies to be given in lowness
of spirits, fainting, or any other kind of languor. “ Sti-
mulants are such medicines as are given to excite and
support the vital powers, having no further operation.”
But it is to be confessed, that of this class of medicines,
many stand no higher in the opinion of sensible men,
and are indeed prescribed, with no other design, than as
mere placebos.

The remedies I am now to enumerate are, the Essen-
tial Oils, (Ethers, Camphor, Aromatics, and Bitters;
which, in their various combinations, comprehend the
polite and modern accomplishment of prescribing ; an
art more prized than all the science of modern ana-
tomists, or the observations of ancient physicians.
Their compounds, if not mere placebos, are comforting
and cordial draughts, vastly like placebos ; the medicines
are such as may be varied or changed ad infinitum;
they are not appropriated to any important class of
diseases ; they are prescribed when nothing else is re-
quired but a momentary excitement ; they are prescribed
in circumstances in which it is no way a matter of con-
science with the physician, to be very tenacious, or very
steady, either in regard to the medicine or the form.
So trivial are the occasions on which this class of reme-
dies is most frequently used, that it is by no means easy
to separate in imagination, the prescriptions of Spiritus
cetheris nitrosi, Oils of peppermint or cinnamon, of Aqua
ammoniac with distilled waters, from their usual title,
PLACEBO. But so far as it is possible to prescribe those
by system, and with a bona fide intention, it must be
by recollecting what the diseases are in which stimulants
may be useful ; and these seem to me to be chiefly as
follow.

1st, In faintings and hysteria, in nervous fits, and

. OF DEBILITY — AND VERTIGO.

171

nervous dyspnoea : In those delicate and irritable females,
who are subject to all the anomalous symptoms termed
nervous, in whom it often happens, that after faulting
there come on slight convulsions, and long insensibility,
the pulse low and tremulous, the breathing suspended for
hours, and the patient lying in a state of nervous languor!
Stimulants, or in other terms, cordials and exciting
powers, are requh*ed. — Heat applied to the cliilled extre-
mities, and cold water dashed upon the face and neck,
equally tend to excite the system. Draughts of am-
monia, or of nitric and sulphuric cether ; turpentine and
opiate glysters ; friction, smelling of ammonia ; CE-
ther, warai alcohol and water, and in an especial man-
ner the golden tinctures, or spirituous distilled waters
of the German practitioners, are given to restore and
re-animate. These stimulants give that immediate and
temporary excitement which is to be seconded by tonics,
nutritious diet, and such medicines as tend to promote
and regulate the secretions

2<Z, Next to this nervous debility to which delicate
women are subject, even in youth, are those vertiginous
complaints, fainting, feebleness of limbs, and slight
palsy, which marks in extreme old age the period of ap-
proaching dissolution. Palsy is not in aU cases the effect
of arterial action, and gorging of the vessels, produc-
ing internal compression, such as to affect the function
of the brain ! When the brain is deserted of blood, its
function fails more instantaneously, than even when it
is oppressed : — from loss of blood we faint, the circulation
being suspended, on which the office of the brain en-
tirely depends : — from terror, fear, or grief, circulation is
suspended, and we faint : — from long-continued fainting
palsy often ensues, the circulation of the brain returning
only partially ! — When in a state of great languor and
weakness, we rise suddenly from the recumbent pos-

172

OF STIMULANTS IN PALSY.

ture, the circulation within the brain fails, and we I
faint ! I

• Very old men, men who are emaciated in body, and I
pale and shrunk in countenance, from the circulation I
having become habitually languid, are from time to time I
affected with giddiness, and become sick and pale : they I
in the end fall down in a fit of sickness and faintness ; I
and though they never are insensible, nor apoplectic, J
and have no flushing, nor other mark of vascular action
or congestion in the head, are found, upon being raised .1
up, to be paralytic of one side. I

- This is one of the occasions in which high stimulants a
and spirituous cordials are useful. To bleed a paralytic offl
this description, would be a flagrant misconduct. The I
cordial spirituous waters, warm brandy and water, am- I
monia, sulphuric oether, or the spiritus oetheris nitrosi, I
are to be given in di’aughts to restore and awaken the I
neiwous energy, and to animate the circulation, which is I
to be farther sustained by generous wines and rich diet ; I
by mustard, horse-radisli, aromatics, bitters, and steel me- I
dicines, by electricity too, and if the paroxysm of faintness I
and insensibility continue long, by stimulant glysters of |
tui'jjentine and aloes. 1

Sc?, In those severe pains of the stomach, which are I
so frequent in dyspeptic and hypochondriac patients ; in I
violent paroxysms of hysteria, in which the patient 1
grasps the stomach with the clenched hand, and tosses I
in agony ; and in all' those sudden pains of the stomach I
to which the most healthy are liable, stimulants, ]
which some will choose to call antispasmodics, are to be |
given without delay, and almost without reserve, espe- I
cially OPIUM, (Ether, or Brandy, Oils of Peppermint, |
Aniseseed or fennel, Pulvis Cinnamon! Compositus, Pul- il
vis aromaticus, &c. ; — and it is wise, as soon as an interval
can be procured, to give juleps with carbonates of lime, or

I

OF CORDIALS IN FEVER. 173

magnesia, and diluents and demulcents, if there be reason
to suspect any thing acrid as the cause of the spasm.

^tli. In LOW FEVER, or Typhus, various modifica-
tions of stimulants, but most especially wine, camphor,

I and opium, are to be given. — It is but fi-om want of
I distinction, that there arises the slightest fear or doubt
j of giving such medicines in fever. — Synocha is not
! fever ; Synocha is a mere vascular excitement, a tem-
! porary intensity of arterial action, caused by some local
j disease. But Fever, exclusively so termed, low fever,

' nervous fever, remittent fever, is the operation of a poi-
son (as of Infection, the poison of a wound for example,
in dissecting dead bodies, of Marsh Miasmata, the foul
air of Hospitals or Jails) upon the nervous system :
The brain is poisoned ; the low quick pulse, confused
head, delirium, and trembling of the hands and tongue,
are the principal signs ; and during the prevalence of
this influence, our whole solicitude should be, to sustain
the strength till the poison is exhausted ; just as in poi-
son from opium, or in suffocation by carbonic gas, our
care is to keep the patient awake and excited, and to
support the vital functions till the influence of the poi-
son has expired.

After all our attempts, then, to procure perspiration
and a crisis, have proved ineffectual : when the fever
has settled down into its proper form; when it is
moderate, as in ordinary practice, and in cold cli-
mates, and especially in the fever of young persons :
when the nerv'^ous system and brain are not irrecover-
ably affected : in long protracted, and yet not indo-
lent fever, when there is a rapid, but not feeble nor
trembling pulse, a furred tongue, a confused head, and
slight delirium, with slight twitching or spasms of the
muscles, especially observable in the tendons of the
^vrist^ we begin to support the patient’s strengtli with

l74) SERPENTxirtlA.— COLOn^Cf. — AMMONIA,

diluted WINES in moderate quantities : — we allay th(? |
quickness of the pulse, and quivering of the hands, by
Camphorated mixture, Camphorated emulsion, draughts
of spiritus oetheris nitrosi, and cool fresh air circulating
through the sick chamber : — At night we compose the i
patient to gentle rest, by a moderate draught of tincture
of opium : and always we preserve the bowels in an ac*
tive state. — (Ether sulphuricus given in pleasant draughts,
removes the tremors, and subsultus tendinum, and pre-
serves the patient composed and cool, strengthens the i
pulse, and clears the head, and relieves the anxiety, toss- -I
ing and sighing, and steadies the sickly stomach. '

Those modest unpretending methods carry the patient
safely through the delirious stage of fever. If symptoms i
require other prescriptions, they are stiU from the same I
class. If severe headache, or a degree of stupor, require i
a different excitement, we apply large blisters to the
head, or to the back, or to the ankles, especially where the
strength is sinking, or the low muttering delirium be-
gun. ' The reason why it is so much a matter of indiffer-
ence to which part of the surface the bhster be applied,
is plainly tliis, that a blister is but another form of sTi- <
MULANT ! it conveys, indeed, a sensation merely, but it
is a permanent and powerful one through the nerves of
the skin ; and it is as much a matter of indifference, (in
fever), to which part a blister is applied, as to what part
of the surface heat or cold is applied, or whether, in
giving opium, it be swallowed into the stomach, or in-
jected into the rectum. I

When sickness and languor of this febrile description^ i
induce us to prescribe those forms of stimulant which |
peculiarly affect the stomach, we give draughts of ser-
PENTARIA, COLUMBO, AMMONIA, CAMPHOR, and some-
times BARK, along with those aromatic waters which
serve as pleasing vehicles for stimulants, or with those aro-

arhangemeot of stimulants. 173

matic powders which associate so well with serpentaria,
columbo, and bark.

It is not my intention to enumerate, in the following
list, all the medicines that may be reckoned stimulants,
but the principal stimulants and cordials only. Nothing
perhaps contributes more to decision in practice, than a
correct and scientific arrangement of the means of cure ;
for among the multifarious articles of the Materia Me-
dica, the variety and profusion, and, as in this very in-
stance, the very name and designation, “ Stimulants,”
is apt to occasion indecision. The most natural arrange-
ment of stimulants I can imagine is this.

Universal stimulants, and of a diffusible
kind, such as are fit to rouse and support the vital
powers, in that most dangerous of all diseases. Fever ;
when the springs of life are tainted by the poison of
foul air, or of infection ; and when our main purpose is,
to support the vital powers till the influence of the poi-
son ceases. They are, wine, opium, alcohol, cether,

CARBONIC ACID, CAMPHOR, SERPENTARIA, CINCHONA,
BLISTERS, and sinapisms.

2d, Acrid stimulants, useful in Palsy and Chronic
Rheumatism, in Amenorrhoea, Gleet, and Fluor Albus.
Those are, arnica, armoracia, sinapis, terebinthi-

NA, LYTTA, ammonia, IRON, SQUILL, COPAIVA.

3d, Stomachic stimulants. Antihysteric Medi-
i cines, and such aromatics as have a stimulant power,
j but are chiefly useful as vehicles for other drugs. These
i are, ginger, capsicum, or cayenne pepper, essen-
I TiAL OILS, as those of peppermint, cinnamon, or fen-
1 nel, of pimento, and of oranges.

Thus, then, stands arranged the catalogue of our sti-
mulant drugs, not of all, but of the more valuable*

176

OF WINE.

1st

ViNUM,

Alcohol,

Acidum carbonicum.
Camphor,

2d.

Arnica Montana,

CoCHLEARIA, ^

Armoracia,

SiNAPIS,

Terebinthina,

CoPAIVA.

Serpentaria,

Cinchona,

Epispastica,

Sinapina.

Lytta,
Ammonia, '
Ferri carbonas^

sulphas.

Sc ILL A,

3d.

Zingiber,
Capsicum,
Mentha piperita,

CiNAMOMUM,

Anethum,

Fceniculum,
Pimento,
Aurantium,
Therm.® bathoni.®
et buxtonienses.

Balneum frigidum.

' There are not many of those medicines that require
a particular description, after the progress already made
in recapitidating the virtues of individual dmgs ; and
there are many, as Alcohol, Wine, (Ether, and Cam-
phor, or essential oils, which follow each other in classes,
where the individual article to be preferred can hardly
be distinguished, otlierwise than as more or less accept-
able to the taste or the stomach.

^Vinum, Wine, a compound of sugar,

acid, and alcohol, in various proportions, is, according to
its kind, useful in various diseases, and is always a most
precious remedy, being a powerful support of the vital
energy, acceptable to the palate, and gi’ateful to the
stomach. Port wine, a stimulant accompanied with a

OF WINE AND SPIRITS;

177

degree of narcotic power, is also useful as an astrin-
gent. Port is thence particularly useful in dyspep-
tic complaints, in diarrhoea, in dysentery, and in the ca-
liectic habits of feeble ill-niused children, who should
have half a glass of port wine as a medicine repeated two
or three times a-day.

In fever wine is an invaluable remedy, not to be re-
placed by any from the shop. In fever, (low fever
surely, for no other is properly fever), our chief care is,
to support the vital powers till the effect of the poi-
son which caused it expires : and wine, while it sup-
ports the - vital powers, plainly lessens the affection of
the sensorium, and at once abates the delirium, revives
the strength, and steadies the pulse. In fever, the best
wine is claret, or diluted port, drunk cold, and given to
the amount of a bottle in the day ; more in the last stage,
or worst species of the typhus ; and to the extent of two
bottles in sphacelus or gangrene. In gout, when the
disease attacks the stomach, or invades the head, strong
Madeira or brandy must be allowed : In the convalescence
from gout, fever, or dysentery, Rhenish wine, (old hock),
is the best cordial and astringent.

Alcohol, though a powerful stimulant,

is rarely used alone ; it is usually reinforced by stimuli
still more powerful, especially by ammonia ; often also
it is joined with bitters, with camphor, &c. ; and those
combinations are particularly prescribed in fevers. Ty-
phoid fevers. CEtheu stjLPHURicus alcoholisato-
CAiMPHORATUS, is such a combination, viz. a drachm of
camphor dissolved in an ounce of sulphuric oether : the
dose is from half a drachm, which contains three grains
of camphor, to a drachm, repeated three or four times
night and day in low fever : In hysteric faintings it is
also useful. This, applied externally, is the best cooling
embrocation in external inflammations.

VOL. HI.

n

178 OF AMMONIATED ALCOHOL AND CETHER.

Alcohol ammoniatujm, the mixture of

one part of liquid ammonia with two of alcohol, is pre-
scribed in the same dose, of half a drachm or a drachm
in asthma, as a stimulant and antispasmodic ; and also
in’ hysteria, but most especially in the paralysis of old
and extenuated habits.

The ALCOHOL DILUTUM AMARUM, is a

far less pleasing form, indeed I know not wliy it shoidd
bear the title of Alcohol. It is no more nor less, than i
an intensely bitter tincture of gentian and wormwood, i
in ardent spirits ; not a very elegant, biit rather a sick- j
ening prescription ; not adapted to fever, hysteria, ner^- j
vous languor, or paralysis, but appropriated to languor (
of stomach and dyspeptic complaints. It is prescribed •
in doses of two or three ounces a-day, diluted with cin-
namon or any other distilled water: If reinforced by
the stimulant and diuretic powers of turpentine, if to
each dose, to each ounce of the bitter alcohol, be added i
fifteen or twenty drops of spirit of tui-pentine, it forms
a medicine particidarly serviceable in dispelling the re-
mains of dropsies, and restoring the strength and gene- .
ral excitement of the system. It is a coarse medicine, ,1
fitter for the military hospital or poors-house, than for
refined practice ; yet it is a useful drug.

ffiTHER suLPHURicus, already described !:

as an antispasmodic, is often found a precious medicine
in low fever. The best form in which it can be given,
is in combination with camphor. The oethcr sulphuri-
cus camphoratus already mentioned, the drachm of which
contains from six to eight grains of camphor, thirty
drops, conveying less than four grains of camphor, may i-
be given dropped on sugar, in cardialgia, hysteria, hiccup,
or any kind of spasm ; or in a draught repeated three or
four times a-day, in low fever. Its immediate effect is,
to lessen the anxiety, relieve the breathing, raise and

ACiUA ACIDI CARBONIC!. 179

strengthen the pulse, and produce a moisture on the
skin ; in short, it is a cordial and diaphoretic.

— Acidum carbonicum, is the medicine

which should have been placed next to wine, as a re-
freshing cordial in fevers ; with this distinction, that
wine is more adapted to the last stage of fever, and to
that which is attended with low muttering delirium,
while this is adapted to the early stage of fevers, attend-
ed with vomiting and incessant sickness.

The AQUA ACIDI CARBONici, is in my opi-
nion the best form in which we administer the caibonic
acid, combined with a little sugar, citric acid, and Ma-
deira wine. The Aqua Acidi Carbonici, is the better
part of the effervescent draught : or it may be given
without addition, to the amount of two or tliree pounds
in the day. It is a refresliing stimulant, exhilirating, and
to some, intoxicating beverage ; useful especially in the
less malignant fevers, in sickness, in vomiting', and in dys-
pepsia. When used in dyspepsia, it is best combined
with another powerful and very universal stimulant,
iron, which diffuses its influence more universally through
the system than one would expect ; and changes very
I suddenly the state of the circulation, the complexion,
I the secretions, and the colour of the blood. An iron
j wire being suspended in the aqua acidi carbonici, dis-
i solves, and gives the full impregnation of a mineral fer-
! niginous water, an excellent light preparation, a stimu-
! lant and tonic.

Ammonia, which is in asthma so power-

I ful an antispasmodic, is stiU more frequently used as a
stimulant, anodyne, and cordial. In hysteric faintings
it is the stimulant most used of any ; in grief, dejection,
lowness of spirits, and hypochondi'iasis, it seiwes as an
excellent anodyne, much preferable to opium ; in the
palsy of old age, proceeding from debility, and appear-

180 USES AND COMBINATIONS OF AMMONIA.

ing first in the form of a slight paralytic shock, viz. by
vertigo and fainting, a dose of aqua ammonias is the best
stimulant medicine ; and continued two or three times
a-day, and seconded by the external application of aqua
ammonias to the palsied limbs, it is a medicine the most
likely of any to restore the sensibility and muscular i
power of the part. To further its effects, it is combined i
with a variety of medicines, iron, valerian, and aromatics. \
First, In the form of carbonate of ammonia, it may a
be given in doses of two or three grains, from hour to
hour, as in the mixture prescribed in tlie Section of Ex- !
temporaneous Prescriptions ; a form, in which it is par-
ticularly appropriated to hysterical affections, lowness i
of spirits, or stomach complaints. — Second, It may ,
be given combined with iron, in the form of am-
MONlATED IRON, wliich is prescribed as a bolus,' to
the amount of ten or twelve grains two or three
times a-day; this form is jieculiarly adapted to dys-
peptic complaints. — Tliird, It is successfully combined
with VALERIAN, in form of draughts, adapted to hyste-
rical and menstrual affections, and to nervous headaches, ^
and given also in low fevers, or intermittenfs, accompa- |
,nied w’ith pain and weight of the forehead. — Fourth, j
Combined with aro:matics, in a mixture of which a fe>v j
spoonfuls are given occasionally, it is useful, like cam- i
phoi-), in the last stage of low fever, to sustain the vis |
vitae. — Fifth, To aid its stimulant power, when the ir- i >;
ritability of the nervous system has almost expired, from } li
a gradual waste of the body, it is often combined with 1 11
liYTTA VESICATORIA. Tliis approximates it to the acrid
medicines, and is peculiarly adapted to the shaking palsy
of old age, and more especially to that palsy which is
attended with debility, and feebleness of the lower ex- i
tremities, and incontinence of urine.

Arnica Montana, Leopards-Banc, the ‘

OF arnica in palsy and rheumatism. 181

flowers, herb, and root, is found chiefly in Germany and
Switzerland. This herb is an acrid stimulant, with a
bitter aromatic taste, and is apt to excite vomiting, es-
pecially the powder of the herb itself : It is a cheap,
rather coarse, but very effectual febrifuge, and a fit substi-
tute for Cinchona ; but is more distinctly stimulant than
the Peruvian Bark: It quickens the pulse, and excites the
sanguiferous system ; it sharpens sensation so imme-
diately, as to cause a universal prickling, hke that of a
limb benumbed, and recovering from compression,
^sleeping, as it is vulgarly termed) : It is fi*om those
qualities useful as an emmenagogue ; it is useful also in
chronic rheumatism, and most of all, useful in the palsy
of mere debility and advandng age, especially when at-
I tended with incontinence of urine.

The powdered root is given in low fevers, and in
j the w’^ane of dysenteric complaints, in doses of thh*ty
j grains three or four times a-day ; but the infusion
; is the form universally prefeired. In making the
j infusion of the leaves, they must be wrapped up in
, a piece of hnen, to prevent the prickly down from
being diffused in the fluid, for it occasions burning
and irritation of the throat. Three drachms of the
leaves infused in a pound of boiling water, makes a
! strong infusion, which may be taken by cupfuls in the
I course of the day ; and its powers are sensibly quicken-
ed, especially in the last stage of typhus, by adding half
an ounce of nitric, or of dilute sulphuric oether, to the
decoction. In fever it supplies well the place of Peru-
vian bark ; but in truth, wherever in the last stage of
fever stimulant remedies are requned, wine supersedes
all others. Where a decoction of bark might with pro-
priety be used, Arnica, or Arnica conjoined with Pem-
vian bark, wiU be found more effectual in supporting the
pulse, and promoting the secretions ; but it is chiefly

182 HORSE-RADISH. — MUSTARD, kc.

excellent in chronic Rheumatism, in Paralysis, and Is-
churica Paralytica.

CocHLEARiA ARMORACiA, Horsc-radish-

root, is too much an article of food, to be higlily valued
as a medicine ; yet it is a slightly acrid stimulant, hav-
ing a very general influence on the sanguiferous system,
which it affects to its very extremities, and excites ac-
tion in the very remotest glands. Hence its use in _
scurvy, or debihty from unwholesome food, moisture, |
and want of exercise, whether by sea or land. It is
used in scrophiilous debility, which arises from peculiar
weakness of fibre, or from a longer prevalence or habi-
tual subjection to the same causes : It is useful in the ^

dropsical effusions which follow agues and slow fevers ; ^

in chlorotic debility, where menstruation is sparing, or I
quite suppressed from feebleness of constitution ; and
last and most of all, important is its use in palsy.

In palsy, the shaved root of horse-radish may be eaten
in the quantity of one or two drachms twice or thrice
a-day ; or taken in the form of expressed juice, a table-
spoonful of which may be given morning and evening ;
or in infusion, a cupful of which may be taken in rheu-
matic or scorbutic cases, three or four times a-day. Al-
ways the sliced root, soft and recent, may be apphed to '
the affected parts, with especial advantage in rheuma-
tism, and even in palsy, and that without blistering the
skm.

SiNATis, Mustard-seed, another acrid sti-
mulant, so much resembling the horse-radish in all its
properties, that what is said of the one might be repeat- I
ed of the other ; with this difference, that externally ap- '
phed, this is the more acrid, the more powerful, and the
most frequently used. Mustard-seed is useful in dys-
pepsia as a stimulant and laxative ; as an emmenagogue
in chronic cases ; but chiefly it is useful in those twp

OF SINAPISMS.

X83

diseases which I find to be so nearly allied to each other,
viz. Chronic Rheumatism, and the Palsy of frail and de-
bilitated habits. A botanical history of mustard, or any
such familiar ailicle, is not to be expected here ; the me-
dicine is always at hand, and always good. The entire
seeds slightly bruised, are given to the amount of a
table-spoonful, in a cup of water every morning, in
dyspepsia and amenorrhoea. In rheumatism, and in
palsy, we add every night at bed-time, a draught, a
large tumbler fiiU, of the mustard whey, viz. an infusion
of bruised mustard-seeds in milk, boiled afterwards with
vinegar, or Rhenish wine.

The most precious use of mustard is as a stimulant
application, in rheumatism, palsy, or the last and mortal
j stage of typhus. In rheumatism and palsy, one of the
best applications is the quack medicine known by the
I name of Essence of Mustard, in which the acrid prin-
I ciple of the mustard is reinforced by a strong im-
I pregnation of spiritus terebinthinie. But in low fever,
j when blisters to the ankles have failed to rouse the vital
powers ; when stimulant medicines can no longer be
swallowed ; when the strength is ebbing fast, with a low
, and muttering delirium, a blackened tongue, and dry
i fauces, we apply sinapisms to the feet and ankles ; a
, prescription which, it must be confessed, savours of ex-
treme unction, and can hardly be supposed to succeed.

Aiiistolochia SEiiPENTAKiA, Virginian

' Snake-Root, derives its stimulant and febrifuge virtues
; from that essential oil, which gives it the fragrant cam-
i phor-like smell of valerian. Its virtues are not unlike
! those of camphor, warm, stimidant, febrifuge, and dia-
phoretic in a slight degree ; and I find it often an effec-
tual anodyne, especially when joined with fifteen drops
of tincture of hyoscyamus. It is often joined with cam-
' phor, to abate the febrile headache and low deliiium ; if

184

ABSURD EULOGIUMS OF BARK.

is given in powder or bolus, to the amount of a scinple
three or four times a-day ; or in decoction, or in the
form of draught, to be shaken when given.

Cinchona officinalis, Peruvian Bark,

Jesuits Bark, Pulvis Comitissae, Quinquina, are a few of
the. innumerable names by which tliis far-famed remedy
has been known. Its celebrity exceeds that of mercury,
opium, or any other of the most valuable of our drugs :
many accidental circumstances conspired to give it a
factitious value. It was brought from a very distant
country, in an age when all were equally ignorant, and
equally fond of the maiwellous ; it was introduced by
Jesuits, intriguing, and disposed, in all courts and king-
doms, to trumpet forth its incredible vutues : it had
happily cured of an intermittent fever, the lady of a
Spanish viceroy, the Countess of Cinchona : marvellous
tales were recited of Indians, aye, and wild beasts, cured
by drinking from pools into which the bark trees had
fallen; and the bark was brought home, with such difficul-
ty and mystery, and in so small a quantity, that it could
be given only to princes, and was estimated at its weight
in gold. I mean undisguisedly to express my dissent
from those who have praised cinchona as a panacea, and
to intimate my doubts of its being very usefid in any
disease, one excepted, intermittent fever.

From our medical histories it would appear, that for
nearly two hundred years, the great contention has been,
who should give, or, to use the magnificent word, exhi-
bit this favourite remedy, in the greatest variety of dis-
eases; and who could praise it most extravagantly. There
is no disorder in which I have not found it useless ! for
which I do not find it praised ! — it is extolled as efficacious
in every opposite disease, in spasms and hooping-cough
first ; and then in smaU-pox and measles ! — in fever and
scrophula ; in gangrene, and in rickets ! — in phtliisis and

BARK ADULTERATED.

I8a

dysenteiy ; in the plague, and in dropsy ’ — what rational
man can hearken contentedly to this ?

It will be easily imagined, that I am not prepared to
write the eulogium of Peruvian bark ; though I hope
no one will believe, that I am capable of denying the
multifarious properties of a medicine which I have not
fairly tried. I do protest that I was sanguine in my
expectations of finding Bark useful in many acute disor-
ders, and certainly in the wane of all diseases. My
doubts have all arisen from disappointments; I have
supported a spiiit of credulity as long, as willingly, as
perseveringly, as most of my felloAv-labourers, but can-
not say that I have been often gratified by success.

But there is one fact, which may perhaps ex-
plain my scepticism, and that of many sensible men
with whom I have conversed on the subject : of one
hundred pounds of Peruvian bark brought to these
countries, (so great is its value, and such the temptation
to deceit), not five pounds are genuine ! “ Corticis cin-
chonae officinalis, centum librae, ad nos adlatae, vix quin-
que vel decern genuinas, ut experientia docet baud equi-
voca, praebent.” — Wylie, p. 41.

There is one disease in which it is so indisputably
useful, much as it may be adulterated, that in it the
medicine may be reckoned a specific, — in vAGUe ; and
since it is, in Intermittent Fever, so conspicuously, so
decidedly a cure, we cannot avoid a sort of persua-
sion, that in Remittent and in Low Continued Fever,
it may be useful ; and from this prepossession have I
placed it by serpentaria. I shall not be at much
pains to detail its botanical history, which is as yet
avowedly obscure ; nor to distinguish the properties pe-
culiar to the several species of red, pale, and yeUow'
barks ; but not choosing, at my own peril, to treat too
slightly a medicine so highly commended, I shall give

186

MANNER OF GIVING BARK.

specimens in the next Section of this Work, of the forms
and doses in which it may be most advantageously pre-
scribed.

The diseases in which I believe Bark to be most con-
spicuously useful, are, in Intermittent Fever, Cynanche
Maligna, and Gangrene ; in Contagious Dysentery, and
Low Continued Fever. In the former diseases, it
must be given with unspaiing hand, in doses as large
and as frequent as the stomach or bowels will bear. In
continued fever, it is best given in form of infusion, or
decoction; or in the form of julep, conveying a mo-
derate dose of the poivder, suspended in some mucila-
ginous fluid ; or with a proportion of the spirituous tinc-
ture, or in combination with seiqjeiitaria.

It is the bark of a tall mount<iiii-tree growing in the
province of Quito, in Peru. The demand has long been
such, that the tree, which is destroyed when despoiled of
its bark, has become rare, small, and degenerate: The bark
imported into this country is sophisticated, or is repre-
sented by others of the same species. Its vhrtues reside
in its tannin, or astringent principle, combined with a
small proportion of essential oil, and of aroma. It is
not perceptibly stimulant; it is bitter, and to many
nauseous : given in any considerable doses, it loads the
stomach, brings sickliness and constipation, and some-
times excites diarrhoea. The dose of bark must there-
fore be conjoined, sometimes with aromatics, to make
it sit lightly on the stomach ; sometimes with opium, to
prevent its purging ; and in the convalescent state, whe-
ther from ague, fever, cynanche maligna, or dysentery,
it should be conjoined with sulphas ferri and other as-
tringents. But tlie sulphas ferri, with whatever astrin-
gent it is used, must not be combined directly in the
same draught, but given separately at a different hour.

To take bark in substance, 'and in large doses, with-
out endangering nausea, it should be gi^ cn in milk, or with

TI NCTURE AND EXTRACT OF BARK. 187

extract of liquorice, or in form of a soft bolus, made mth
marmalade ; or, best of all, by taking a piece of extract
of liquorice in the mouth, till the tongue and fauces are
thick coated with the mucilaginous extract, and the
p^ate so impregnated with the bitterish-sweet of liquo-
rice juice, that it mixes with the bitter of the baik,
which is then scarcely discernible. Or it may be com-
bined with the liquorice, and almost suspended by it,
in a di’aught, to be repeated from hour to hour, or in
mixtures.

For an infusion of bark, two drachms saturate a pound
of boiling w'ater ; and the infusion is as perfect in two
hours, as in twenty-four. The tincture of bark, (Tinc-
tura Cinchonee Composita), in which it is combined with
snake-root, and orange-peel, is an excellent stomachic
bitter, and an ounce or more of it is often added to an
infusion or decoction of bark : But of the extract of
bark we cannot say even this ; it will not cure an inter-
mittent ; it is hardly useful as a stomachic ; it is a use-
less, expensive preparation ; the bark is actually decom-
posed, and its best virtues lost in the process. Were it
not that there is much placehoism in prescribing bark,
this same extract would, upon the authority of our best
chemists, be thrown out of the Pharmacopoeia.

I hold bark of little value in any diseases, except in-
I termittent fever, and in full and frequent doses : but,

! far from feeling myself entitled to dissuade others from
j using what has been long thought, next to opium and
I mercury, a valuable medicine, I shall, in the Section of
1 Extemporaneous Prescriptions, be at pains to lay before
! my reader the most approved forms of prescription, of
powder, piU, electuary, draught, and mixture, infusion,

! decoction, and injection.

. . Capsicu]vi annuum, Indian Pepper, op

, Cayenne Pepper ; the pods, seeds, and dry loose pulp,

188

CAPSICUM. — GINCEIt.

I

erf* the capsicum, are all mixed in the spice, as it is
brought to us from the West Indies. It is not acrimo-
nious in the sense that mustard, horse-radish, tiupen-
tine, &c. are, but intolerably hot, and intensely stimu-
lant. Its uses as a seasoning in curries, sauces, apd
soups, correcting the acescent tendency of vegetable
food, and preserving the stomach in vigour, is well i
known even in this country ; and in warm countries, ?
such spices are essential to digestion and health. It is a ;
pure stimulant, contains nothing narcotic, nor ultimate- i
ly deleterious of the powers of the stomach ; it prevents i
acidity, promotes digestion, and supplies the place |
of the more dangerous stimulants, spirits and wina I
Wlien given in dyspeptic complaints, it is usually in 4
form of pills, combined with aromatics, and given to
the extent of five or six grains, repeated tluee times -
a-day. It is advantageously combined with absorbents
and aromatics, as Cinnamon and Magnesia for example.

A dilute infusion of the capsicum is much used in
chronic ophthalmia. Capsicum is, in 'tropical countries, 1
applied externally as a stimulant in low fever, as we use 1
mustard or Lytta in this country : It stim\ dates and ex- ;
cites powerfully, yet without blistermg. For such pur-
poses, and especially for the cure of cynanche, it is in-
fused in strong vinegar, and rubbed on the throat, and
over the place of the tonsils. 1

It is also internally used as a stimulant in low fever, j
especially in the last stage, and in yellow fever : Three t
grains are given in form of pill, with half a grain of 1
opium, and repeated every three hours : the pills, too t
acrid to be swallowed without pain and sense of sufFo- ■
cation, are either given in wafer, or involved in a coat
of kneaded crumb of bread, or coated thick with mu-
cilage.

Ginger is another hot and aromatic spice,

PEPPERMINT.

189

useful as (jonspicuously as a seasoning for di-ugs, as for
viands. The syrup of ginger is an excellent and pleas-
ing vehicle for all varieties of medicine ; the powder of
ginger I like to mix with those absorbents which are
given in dyspeptic complaints^, in pains of stomach, or
in that weakness which remains after protracted dysen-
tery. It is mixed with super-tartrate of potass, and
other saline purges ; with all those medicines which
are given in amenorrhoea, in the purges and ano-
dynes prescribed for flatulent cohc of the lower in-
testines, and in the infusions of gentian, and other
stomachic bitters; Without prescribing doses of gin-
gerj the purpose of using if is here so expressed,

1 that when it is found among the extemporaneous pre-
I scriptions, the purpose will be conceived. The powder
j of ginger is sometimes, as a .Simulant and astringent,
applied to relaxed tonsils, taking up a pinch of the
powder, and laying it with the point of a paper-folder
; into the hoUow of the tonsil.

I Mentha piperita, Peppermint, the

leaves, a common plant, affords yet one of the most
I powerful cordials. An acrid, stimulant oil, having much
I of the camphor principle, volatile, and easily forced
i over in distillation, constitutes the chief virtue of this
i medicine. This principle presents itself for practical
i use in two forms ; in a distilled water, when the oil is
1 diffused ; and in pure oH, which is the form in which
1 the medicine is most powerful. As a vehicle, merely,

■ for other stomachic drugs, the distilled water is most
t familiarly used ; but when we would put forth all the
• Strength of the medicine, it is in form of essential oil.

The oil of peppermint dropped on sugar, is a very
powerful cordial in gastrodynia, or pain of the stomach
void of inflammation, and in hypochondriacal and hysteric
affections of the stomach and bowels. In cramp of the

i

190

CINNAMON, AND ITS OIL.

stomach, it is best combined with opium, in form of
pill, of powder with sugar, or of draught. In the coim
position of all cordial drauglits, pills, and powders ; in
the eomposition of stomachic pills and powders, or warm i
emmenagogue medicines, it is a precious ingredient.
But I never could find febrile patients benefited by such
a prescription, nor could they even bear it.

• The leaves of peppermint may be given in form of
powder, from a. scruple to a drachm for a dos^t, two or
three ounces of the distilled water may be given at a
time ; and ofr the essential oil, from two drops to five. '
Laurcts cinnamonum, Cinnamon, an-
other stimulant aromatic, requires no detailed descrip-
tion ; it is an equally powerful and much more pleasing
stomachic stimulant, and one which it is much more natu-
ral to prescribe in form of powder. Cinnamon is in effect
so acrid, tliat the surgeons whose province it was, undei '
the Dutch government, to taste and assort the spice for
the depots of it at Ceylon, found their tongues and
fauces so tormented and ulcerated, that they could not
long continue the process of tasting. Another proof of •
its intense power is, the effect of oil of cinnamon, be- '
yond any other essential oil, in deadening the nerve of
a corrupted tooth, and at once assuaging the pain of it.
This medicine is at once pleasing to the taste and sense,
and gratefid to the stomach ; the powder is an ingve-
dient indispensible in cordial, astringent, and stomachic
poAvders, and thence much used in powders, whose
chief virtues lie in the magnesia, chalk, serpentaria, &c. ;
with these it is often joined. 1

The distilled water of cinnamon is the common '
vehicle of cether, spirit of nitre, camphor, and other
medicines, given in draughts. Its essential oil, more
powerful and grateful than any other, is exception-
able only on account of its price ; and not on its price

ANETHUM. — PUI-EGIUM. — PIMENTO.

191

truly, because there are few occasions in which we
could grudge, even to the poor, the most expensive,
or, as they were formerly designated, heroic and prince-
ly medicines, but because its price is a motive for adul-
terating it. Two or three di’ops of oil of cinnamon,
have a powerful effect in a stomachic pill or powder,
especially in pains of the stomach, and cramps.

Anethum fjeniculum. Sweet Fennel
Seeds, have the same stimulating aromatic properties,
but the oil these seeds afford is coarse, neither pleasing
nor powerful, compared with those just described. A
drop of the distilled oil is often given in the colic of in-
fants, along with their dose of purging syrup, or of
magnesia and rhubarb ; or a few tea-spoonfuls of the
FENNEL WATER are given to a child as a carminative.
Infusion of fennel is made, with two drachms of the
I bruised seeds to a pound of water: of the distilled
I water, three ounces are given for a dose to an adult, and
I from two to five drops of the essential oil.

j Mentha pulEgium, Penny-royal, is an-

1 other of the tribe, resembling spearmint, and giving out
i to distillation a less pleasing essential oil, or distilled
I w'ater. It is strong in the stimulant property, is much
used among the poor, especially in the hooping-cough,

I and in the colics of children. An infusion of this minth

I

in white wine, with steel-filings, was esteemed by Hal-
ler as among the most powerful emmenagogues.

Pimento, Jamaica Pepper, or iVH-spice,

as it has beeh named, from having a taste of each, viz. of
cinnamon, cloves, and nutmeg, is among the most accep-
table of the aromatic stimulants, not for its powerful
effect, nor for any essential oil extracted from it, but from
its pleasing flavour in the form of distilled water. It
serves as a vehicle for whatever medicine w^e wish to
prcsci'ibe in a pleasing form.

I

I

192 OF KUBEFACIENTS AND EPISPASTICS.

' These are the tprincipal stiinnlantb, some of which are
used for their power and efficacy, others as vehicles, and
others^ as it will' be perceived, as placebos. We turn
from them to ‘that invaluable class of applications, the
EXTERNAL STIMULANTS or RUBEFACIENTS. <

' • • jj j: - «■

' Class VIII.

OF external stimulan'Fs, rubefacients, and
' ' + epispastics. '» 1

' 1*^ 0 ! ■ ’ •(:

I REDaRD this class of medicines, not as a trivial ap-
pendage to the stimulants which w'e use internally, but
as a supplement to the whole materia medica ; for I
haixlly know the medicinal process which would not be
imperfect, without corresponding medicines externally
applied. I shall endeavour to illustrate my opinions on
this subject, by submitting to my reader a rational and
very simple arrangement.

As far as I can recollect, external stimulants are used
for one or other of the follo^ving purposes : — 1st, Their
most direct and natural use is, in reinforcing the power
of stimulants given internally, to sustain the sensorial
power in those circumstances in which it is most fatally
affected, viz. Fever or Palsy. In fever, infectious fever,
the nervous system is assailed by a subtle poison, the
influence of which must expire before the patient can
recover ; and while its influence prevails, especially in
the latter stages, w'e must ply all our stimulants, exter-
nal as well as internal ! To wine, camphor, and opium,
we add sinapisms and blisters. But in palsy, the ner-
vous influence is partially destroyed, by a direct injury
of the substance of the brain ; and being weakened in
the extremities, demands, along with internal stimulants

VARIOUS USES OF STIJVIUUANTS. 193

and cordials, the use of acrid stimulants, as ammonia,
mustai’d, &c. externally applied.

^d. In chronic rheumatism, a disease singularly allied
with palsy, rigidity being, in this disease, conjoined
with torpor, insensibility, and feebleness of the limbs,
the same external stimulants are used, but combined
with oils, and assisted by friction, to restore circulation
and feeling to the diseased members.

3c?, We often employ external stimulants for purposes
directly the reverse of aU those hitherto defined, viz. to co-
operate with sedatives, narcotics, bleeding, and aU other
debilitating powers : for, while we seek to moderate the
intense arterial action which endangers the mechailism
of some important organ, by emetics, opium, or digita-
lis ! we endeavour to turn aside the tide of blood from
the parts thus threatened with destruction, by exciting
the action of other sets of vessels ; we relieve the brain,
the lungs, the viscera of the abdomen, and the delicate
internal mechanism of the joints, by rubefacients, blis-
ters, and stimulants.

4dh, There are certain circumstances of inflammation,

I in which the superficial vessels of the skin and its cel-
! lular substance being highly excited, all our efforts
I to allay this action, and to resolve the inflammation,
fail ; it then becomes our duty to assist the process of
suppuration, as the only means of putting an end to
the incited action. We seek to promote the effusion
of gluten, by the more kindly stimulants of gentle and
relaxing heat, moisture, poultices, oily embrocations ;
and if the suppuration be slow, and seated in a gland,
we use plasters of various stimulating gums.

If certain medicines of the stimulant tribe corre-
\ spond with those several intentions, then must it be a
great pleasure to the young physician, to find the qua-
lities and the uses of the several stimulants indicated by
! VOL. ni. N

i

arrangement of stimulants.

m

the order in which they ai-e arranged, — to find, in short,
the aids best adapted to forward and assist his several
processes, ready at hand. — By tliis he will feel himself
insured against the most painful and dissatisfied feeling,
viz. that of using external stimulants promiscuously,
yet busily, witliout one distinct or rational^ intention !
applying a blister, or some other intense stimulant, with
no more regard to propriety than if he were prescribing
a placebo, and without any apology but this, that an
external application can hardly be a poison. Yet I
think I have seen an ill-timed blister, or irritating sti-
mulant, unadvisedly applied at a critical moment, do
harm equal almost to a poison.

It is not possible that there should be certain orders
of stimulants, precisely and exclusively apphcable to
those several uses : from various and slight considera-
tions, the practical physician Avill interchange and vary
these, as suits the exigencies of the moment ; but still
the several stimulants may be usefuUy an*anged as fol-
lows.

Ace I A, acrid and irritating applications,

fit to excite and support the whole nervous system in
the last stage of fever, and to rouse the sensibility of
palsied parts : Among the principal of those are, Lytta,
Terebinthina, Sinapis, Ammonia, Allium, Scilla, Cap-
sicum, Armoracea, Alcohol ; none of them exclusively,
but aU of them peculiarly, applicable to those conditions
of the system.

2d, Calida, applications more moderately

stimulant ; more gradual and kindly in their operation ;
more suited to the ordinary purposes of exciting the
languid circulation and dormant sensibility of parts,
stiffened with rheumatism, or injured by sprains or
bruises. Here oils are peculiarly useful, and stimulants
combined with oils ; as camphoe, combined with oil or

t<

I i

c

a

II

0

a

n

WARM, suppurating, ANTISEPTIC.

195

axunge ; ammonia, in form of soap ; Soda, and murias
SOD^, in form of fomentation ; — aiicohol and (ether,
with several stimulant gums, as opium, camphor, and
essential oils, which they dissolve ; — Balnea Calida, and
Therm ; and, finally. Friction, after the manner of
Mr Grosvenor, a means of exciting circulation, growth,
and the power of motion, more effectual, as I have
proved in my Quarto V olume on Tumors, than all the
other means united.

3(7, SuppuRANTiA, medicines which, along

with a gentle and kindly excitement of the whole mass
of vessels, have in themselves, or by their mode of ap-
phcation in fomentation, poultice, or plaster, the effect
of relaxing tlie cellular substance, and facilitating effu-
sion. Such are. Allium, Camphor, Ammonia, Opium,
Galbanum, Myrrh, Fix Burgundica.

47/i, Antiseptica, as they have been tenn-

ed, medicines wdiich are supposed to have the power of
arresting the progress of gangrene. If gangrene were
j what the older physiologists imagined it, a tendency of
* the blood, and humours, and w'hat not, to putrefaction !
or a stagnation of blood, by which it became subject to
the usual laws of chemical affinity, the term might have
a meaning : But gangrene is a putrefaction of parts
which have ceased to live, because they have been kiUed
; by the intense action and suffocation of their owm ves-
sels : and the medicines to be applied in gangi-ene are
i merely stimulants, which, by exciting the vessels still
I alive, enable them, by the action of suppuration, to
I throw off the dead parts, or such other medicines as may
i serve, in some degree, to qualify the putrescence of the
; matter already dead, and likely to be absorbed. — The
medicines are. Powders, of Nitre, Bark, IMyrrh, and
! Camphor ; — or Balsams, of Alcohol, Turpentine, and
■ Camphor.

196 FOHMS OF FOMENTATIONS, EMBROCATIONS, &c.

5th, Rodentia, or Stimulants from the-

mineral kingdom, chiefly of power to stimulate intense-
ly, or, if required, to ulcerate the part, and thus carry
vascular excitement, and its consequences, to the highest
pitch. Of those the chief are. Calx, Tartras Antimonii,
Nitras Argenti, Moxa.

To go farther in the enumeration of chemical stimu-
lants, would be to anticipate the surgical, Pharmacopoeia;

I mean now to enumerate those stimulants only, which
are necessary towards completing every medical process ;
and therefore I think it not injudicious to add to my
list Collyria, or washes for inflamed eyes, — Gargarisms,
or washes for inflamed throat, — and Fomentations, for
ill-conditioned sores. — We shall thus have under our
eye, an orderly list of all the external applications,
which it is any time the province of the physician to
administer.

CATALOGUE OF THE PRINCIPAL STIMULANT APPLI-
CATIONS.

I profess not to give a catalogue of all the stimulants
that have been used, or which are now in use, but of
the chief, of all indeed, that can be required, and of
the most approved forms.

There is little motive for engaging in botanical or
chemical details, in regard to applic*ations so familiar :
But there is a variety of form, and manner of applying
those, which certainly adds to tlieir usefulness, and must
be described. Stimulants are applied sometimes in i
form of FOMENTATIONS, or watery decoctions and solu-
tions, especially useful where the purpose is to appease
inflammation, or to promote suppuration ; — of embro-
cations, or solutions of stimulant drugs in oil or spirits,
fit to be poured upon the part affected ; — or of lint-

CATALOGUE OF EXTERNAL STIMULANTS. 197

ments, when the stimulants are mixed with axunge,
wax, or oils of a tliicker consistence, to be applied as
ointments, or rubbed into the parts affected with the
palm of the hand ; — of cataplasm, or poultice, a form
which combines with the stimulant drugs, the powerful
influence of heat and moisture, frequently renewed ; by
such poultices, the parts are moderately excited, and
finally relieved by gently promoting the effusion into
the cellular substance, or, in other terms, by promot-
ing suppuration ; — of plaster, where the stimulat-
ing medicine, though very properly added, has proba-
bly very little effect, compared with the adhesion and
supported warmth of the plaster, as a plaster ; by its
adhesion and continued warmth, tumors, languid in
their vascular action, are induced to suppurate or,
finally, in the forjn of powder, which is chiefly useful
when the inflamed part has burst into an open sore, or
when the extreme violence of inflammation has termi-
nated in gangrene.

To these forms of external stimulants, it is my pur-
pose to add various forms of gargles, collyria, and
injections for gonorrhoea.

catalogue of external stimulants.

LiYtta,

Oleum terebinthin^e,

SiNAPIS,

Anthemis nobilis.
Allium,

SciLLA,

Capsicum,

Armoracea,

Opium,

Myrrh,

Galbanum,

Terebinthina^

Pix burgundica,
Bitumen,

Camphor,

Ammonia,

Soda,

MuRIAS SOD.E,

Alcohol,

CEther,

Moxa,

Calx,

Tartras Antimoni
Nitras Argenti.

198 FORMS and uses OF EXTERNAL STIMULANTS. |

Now, it is not to be denied, that the forms in whicl>
those various stimulants are used, modify their effect ;
and tliat certain forms, as well as particular medicines,
are adapted by nature to certain affections.

l5f. The forms of external stimulants most naturally
resorted to in the last stage of Low Fever, and in Pa-
ralysis, are the most pungent applications that can be
contrived, viz. of Spanish flies, mustard, ammonia, and
turpentine, or of ammonia with camphor, or with tur-
jx'ntine ; or of lime, the most acrid of all, in form of
embrocations, or plasters.

2f/, The medicines, and the forms of medicines, most
naturally used in Chronic Rheumatism, Sprains, Bruises,
Dislocations, and Indolent SwelHngs of the Joints ; in the
thickening and knotting of the joints, caused by gout ; i

or for the resolution of Venereal Nodes, for stimulating I

dropsical joints, &:c. are less acrid than those required in i

palsy, or in low fever. They are hot fomentations of i

IMurias Ammoniae, of IMurias Sodas : Liniments of Soap : ]

Embrocations of ffither. Alcohol, and Essential Oils : E- I

pithems of Turpentine, or liniments of Ammonia and i

Camphor, or of Ammonia, Opium, and Soap, or of all
these combined. * i

Sd, Cataplasms and Plasters, such as I now proceed i

to enumerate, though very useful, and indeed too rarely s

prescribed for pains and palsy, thickening of ligaments, f

and stiffening of joints, are yet more peculiarly appro-
priated to those circumstances in which we wish to pro-
mote suppuration in slow and glandular tumors. 'J’hey
are Poultices with Camphor, Onions, or Squills ; Embro-
cations of Tartris Antimonii ; combinations of JMercury,
camphor, and ammonia, Avith axunge, mbbed into the
tumors; or Plasters of Galbanum, IMyrrh, and Cam-
phor ; or a plaster composed of lime.

Wt, and lastly, Strong Stimulating Decoctions, wann

CLASS FIRST, FOR FEVER OR PALSY. - 199

dressings, as they are called in hospital practice, viz. hot
Turpentines, Ointments, or strong powders, as of Cam-
phor, Myrrh, &c. These are the applications which we
use in sphacelus, mixing the turpentines or powdered
myrrh, &c. with the putrid skin of the gangrened
hmbs.

These shght notices may serve as a sort of general
index for the order in which stimulating applications
are to be enumerated.

First Class of External Stimulants. — The Com-
mon Blistering Plaster, Emplastrum Lyttae Vesica-
toriae, is composed of simple ointment, mixed with
a little proportion of axunge, to give it softness and
ductility, and nearly one half of powder of 'Spanish
flies. It. should be recollected, that ointment, viz.

I oil and wax, deadens or involves all stimulant medi-
I cines ; therefore, in applying a blister, the part should be
I previously rubbed with strong vinegar. It should also
I be recollected, that there are many excellent substitutes
I for blistering plaster ; that the powder of Spanish flies
may be scattered over any simple ointment, spread
on leather, or strewed upon bread poultice ; and that,
in this latter form, they operate very immediately. It
should not be forgotten, that Ammonia, Mustard, Squills,
i even Common Onion, or Horse-Radish, will, with the
help of friction, operate as blisters ; and that, to main-
I tain a serous or purulent discharge in form of issue,
j either a dilute solution of the blistering ointment, or
i the ointment composed of savine, are excellent.

; The Liniment of Ammonia and Turpentine is, next
; to actual blister, the most powerful stimulant we have :

1 It is compounded of equal parts of Liquid Ammonia,

I common oil, Spiritus Terebinthinas, and water, to which,
i when we would give it all the strength possible, we add

I

^0 CAMl^HOR, — AJfMONIA.— POTASS,— MtTSTAUD.

two parts of Tincture of Cantharides. Another embro.
cation, very powerful in exciting paralytic parts, in
resolving the thickening round rheumatic joints, and
in relieving spasmodic pains, is the camphorated li-
niment with ammonia : This is another very effectual
combination of camphor, dissolved in spirits of wine,
mixed witli lard, and strengthened with liquid ammo-
nia. This liniment is useful, not only in exciting para-
lysed parts, and in rheumatalgia, venereal nodes, &c. ;
but those Avho suffer a degree of impotency from want
of excitement, are said to find this effectual,

Potass is often found a powerful ally to those in-
tense stimulants, and is, with this intention, joined
ivith them in the solid form of soap, or Saponaceous
Balsam. The Turpentine Soap is a combination of this
nature, viz. of common soap and oil of turpentine, in
equal proportions, with an added proportion of carbo-
nate of potass. The rubefacient soap liniment is
just this in a liquid form ; it is tui-pentine soap, dis-
solved in spirits of wine, and rendered more pungent
by the addition of more turpentine, together with am-
monia and tincture of cantharides ; all of tliem stimu-
lants sufficiently powerful for tjie purposes even of far-
riery.

Of the prescriptions of mustard I have not yet spoken,
because there is one which supersedes all others, I mean
the Essence of Mustard, easily procured, and well pre^
pared. Whitehead’s Essence of ^lustard, for bruises,
sprains, and rheumatisms, is merely an infusion of mus-
tard-seed in spirit or oil of turpentine, in which the
turpentine is far the more potent ingredient ; and that
it may be made, whenever, by accident, it cannot be
prociued, I write down the proportions : One ounce of
bruised mustard-seed is infused for eight days in a pound
of oi| of turpentine ; and wherever it may be supposed

OP LIME AS A RUBEFACIENT.

201

useflil to strengthen this hot application, two or three
ounces of tincture of cantharides may be added.

These are our most acrid stimulants, and they am
used in exciting paralytic limbs, in stimulating the ge-
nital parts in cases of impotency, in sciatic pains, in
disease of the knee-joint, in thickening of the capsules
of the joints, after sprains and laxations : But when it
is necessary to have recourse to more powerful excite-
ment," there is one stimulant still more acrid, viz. Lime.
Lime is successfully applied as a stimulant thus : You
mix one part of slaked or powdered lime, with two
parts of oat-meal, and knead the powder with hog’s
lard, into the consistence of a thick ointment, or of
poultice, which you apply thick to the loins, or round
the hip-joint, in lumbago or sciatica. You may, with
excellent effect, wrap this cataplasm round the knee-
joint, when, in a feeble and scrophulous lad, it is swol-
len, and thickened, with a pale massive induration of
the skin, ligaments, and periosteum.

Sinapisms are domestic preparations : there is no
occasion to give receipts in scientific form, for the com-
pounding of mustard with vinegar and crumb of bread ;
that were indeed a refinement in the science of prescrib-
ing. The simple sinapism, cataplasma sinapinum
MITE, such as is fit to be wrapped round the ankles in
the last low stage of fever, is made by mixing mustard-
seed with oat-meal, flour, or crumb of bread, in equal
proportions, and moistening and kneading them toge-
ther into the form of a pulp or poultice, to be spread
thick on a linen cloth, and bound slightly round the
ankles, or applied, in form of plaster, to the soles of
the feet. — ^When it is thought necessary, in case of deep
apoplectic stupor, or in total and sudden palsy, to add
strength to the Sinapism, it is converted into the stronger '
sinapism, cataplasiua sinapinttm acpe, by adding to

202 CLASS SECOND, EMBROCATIONS FOR SPRAINS.

the mass one-third of shaven horse-radish, and a like
proportion, or rather less, of the muriate of ammonia.

Second Class of External Stimulants. — The se-
cond class of external stimulants, consisting of Fo- j
mentations. Embrocations, and Liniments, suited not
to fever, palsy, or the worst species of chronic rheuma- j
tism, but to die slighter accidents^of sprains, blows, and I
rheumatic pains, is of course far more numerous, and J
in more familiar use. — The fii’st and most simple of those j

gentler stimulants are, decoctions of Chamomile, of
Southernwood, of Spearmint, and other aromatic herbs. |t

The best fomentation of this kind to bruised parts, is ^
that used in warmer countries, viz. the Lees of Wine, ?
an excellent astringent, and gentle stimulant. Our best j|
fomentations, consisting of aromatic herbs, with the ad- j
dition of vinegar and alcohol, is but an imitation of this. L
The DECOCTUM pro fomento, the common decoction h
for fomentations, is a decoction of Southernwood, Worm-
wood, Chamomile, and Laurel, in equal proportions : But t
it is to be remembered, that the speannint, wormwood, (.

southernwood, &c. are all so very much alike, that j

Chamomile, the most common, may represent them all ;
and the decoction of chamomile, being made strong,
may be still farther strengthened, by the addition of
three di*achms of the muriate of ammonia, and two or
three ounces of common vinegar, with a proportion of
alcohol, or any common spirit : — As a fomentation to
limbs or joints recently bruised, sprained, or dislocated,
it is to be used extremely hot, changing the flannels
every five minutes, and is to be continued (to be at all
useful) nearly an hour at each time, and repeated three
times a-dav.

A similar fomentation, viz. of Alcohol, Vinegar, and
Sulphuric Acid, is veiy useful in stimulating and

VARIOUS FOMENTATIONS AND LINIMENTS. 203

cleansing ulcers left after erysipelas, or in extensive
scabby ulcerations. The Embrocation composed of Vine-
gar, Spirits of Wine, and Camphor, is also very useful
in bruises, sprains, and ecchymosis. The Acetate of Am-
monia, Spiritus Mindereri, is much used in slight sprains
of the wrist and ankle, and in slighter degrees of rheu-
matism ; and acetate of ammonia with soap, is also
much used.

Fomentations and embrocations, more powerful by a
few degrees than these, are formed by combining stimu-
lant applications ; by adding, for example, to the solu-
tion of soap, a proportion of acetate of ammonia, which
may indeed be said to dilute, and of hquid ammonia,
which certainly strengthens, the fomentation. The so-
lution of soap in alcohol, the simple Soap Liniment, is
another of the shghter stimulants, the most frequently
prescribed for rubbing sprained or swollen joints, or the
swollen glands of scrophulous and rachitic children.

The more powerful stimulants of this class are, the
j COMPOUND SOAP LINIMENT, compounded of soap and
! camphor, dissolved in alcohol ; or the same rendered
Anodyne at the same time that it is stimulant, by the ad-
dition of Opium. — The Liniment of Ammonia is a lini-
ment composed of the Aqua Ammonife, mixed with tluee
parts of Oil ; and this again is reinforced, according to
the exigencies of the case, by the addition of Turpen-
tine, almost to the strength of that already prescribed
i for paralytic affections, by the addition of two most
powerful stimulants, viz. Prepared Kali, and Camphor,
i in form of a liquid soap : — or without soap, the camphor
may be simply dissolved in aromatic spirits, which form
a cleanly and very effectual stimulant, such as may be
applied to the swelling of the throat, of the testicle, or
: of lymphatic glands. The ointment compounded of
unguentum resinosum. Camphor, and Turpentine, may

5104. CATAPLASMS, &C. TO PROMOTE SUPPURATION.

be said to close this series of less acrid, and more fami-
liar stimulants, or that composed of oil, turpentine, and
sulphuric acid.

Third Class of External Stimulants. those
Ammoniated Camphor and Turpentine Embrocations,
we have prescribed quite enough, and varied the
forms perhaps too much; we come next to enume-
rate poultices, plasters, and liniments, for promoting
suppuration, by exciting the whole vascular structure of
the part, or, as we may say, the whole mass of vessels
belonging to a swollen gland, or joint, or limb.

Tire DiscuTiENT INFUSIONS, and cataplasms, as they
are called, are really better calculated than any other, by
their heat and moisture, and their gently stimulating
virtue, to promote a kindly and moderate effusion into
the cellular substance of an inflamed part. The discu-
TiENT INFUSION is composcd of Aromatic Herbs ; of
JNIint, Thyme, Wormwood, Origanum, and Chamomile,
in equal proportions. These are infused for an hour in
boiling water, and then brought to boil for a few minutes.
To the pound of this infusion is often added a drachm
of the muriate of ammonia, and two ounces of vinegai’,
or half a pound of alcohol.

It is the residuum of this process, the aromatic leaves
which remain after this decoction, that, by adding to
it a sufficient proportion of axunge, or of simple oint-
ment, forms the discutient poultice. But it is more
properly a poultice for promoting suppuration ! and is
excellently well imitated, by adding to the common emol-
lient poultice, or to lint-seed poultice, or bread poultice,
a proportion of Gum Ammoniacum, previously dissolved
in Alcohol, along with two or three drachms of sal-am-
moniac, and a small proportion of alcohol. These fo-
mentations and cataplasms are what we first prescribe

CATAPLASMS OF ONIONS AND OF SALT. 205

in indolent tumors, swollen glands, and scrophulous
joints.

The CATAPLASMA MATURANs is a Stronger compound,
consisting of Soft Soap, Flour, Roasted Onions, and Ho-
ney; or of oatmeal and honey in equal proportions; — or of
an ounce and an half of Onion to the pound of common
emollient poultice ; — or finally, of onions stewed down in
water, to a soft and thickish pulp, fit for poultice. Lily
root, which was often used of old, being merely mucila-
ginous, is exchanged now for the common bread poul-
i tice, in forming these suppurating poultices.

Sea salt, murias sod^, is a very power-
ful stimulant ; the addition of a proportion of this salt
j contributes greatly to the power of such a poultice,
and not unfi*equently itself is made the sole stimulant
ingredient in a hot poultice, being mixed with lint-seed
I or bread poultice. Murias ammonise is especially useful
I in bronchocele, stpumous lymphatic swellings, salivary
tumors, &c.

[ It has been questioned, whether, in the form of plas-
! ter, these stimulant applications are at all efficacious:
there is no reason to doubt, that the softer forms, viz.
of ointment and liniment, are more propitious to the ac-
tion of acrid medicines ; that the firmer composition of
plaster prevents their influence ; the more intense that
stimulants are, the more fit to be combined with oint-
ments. The stimulant gums combined with resin, in
form of plaster, are better adapted to more indolent and
glandular tumors.

Among the first of these, ranks the Ointment of Tar-
trite of Antimony ; a scruple of tartrite of antimony,

I mixed with one ounce of axunge : Such ointment is
I often rubbed into a white swelling of the knee to ex-
; cite it, or into a glandular swelling to promote suppu-
ration.— The ointment, formed by mixing the nitric acid

!

206 Naphtha. — murias ammonia. — squills.

«

with axunge, in the proportion of an ounce of acid to
Iialf a pound of ointment, is used for the same pur-
pose, viz, of resolving white swellings, and procuring
the suppuration of indolent tumors ; it is besides useful
also in the itch, and in herpetic eruptions,

AU the varieties of bitumen , or mineral oil, whether the i
finer Naphtha and Petroleum, which comes from Modena »
in Italy ; the Barbadoes tar, brought from the islands of j
the West Indies ; or finally, the coarser bitumen dis- I
tilled from pit-coal, and known among the vulgar by |
the name of British oil, are all found very efficacious
in chronic rheumatisms, in white swellings, and in glan- i
dular diseases. These mineral oils may be occasionally
strengthened by the addition of other stimulants ; one of
the best and most approved forms, is the combination of
Petroleum and Camphor,

Murias ammoni/E, INIercury, Squills, &c,

are often embodied in the denser form of stimulant
PLASTER, The form of gum plaster, the plaster
most frequently used, is a compound of wax and resin,
with oxide of lead to give it firmness ; and of Gum Am-
moniac, Galbanum, and Turpentine, to give it stimulant ■.
power. This is a plaster very frequently applied with
the hope of procuring suppuration in indolent tumors,
especially of the glands of the neck and jaws. The gum
ammoniacum is often very judiciously combined with
mercmy, or with squills ; the quicksilver, killed as it is
termed, by long and diligent trituration with sulphu-
rated oils ; the squills dissolved in vinegar, and then
mixed Muth the gum ammoniac.

Fourth Class of External Stimulants. — The sti-
mulants best fitted to support the excitement in gan-
grened parts, and to excite the vessels to the point
of suppuration, are strong stimulant fomentations, and

fomentations and powders for gangrene. 207

antiseptic powders as they are called. The best in-
fusion for fomenting a gangrened limb, is the common
infusion, adding to each pound of it three ounces of
tincture of bark, and three ounces of camphorated spi-
rits, or of camphorated vinegar, with occasionally a few
drachms of muriatic acid, to correct the foetor. — After
being fomented, which should be done three times a-
day, with tliis hot infusion, the gangrened limb should
be wrapped in a poultice of oat meal, barm, and cam-
phor, denominated the antiseptic cataplasm. But the
best application to a limb so gangrened, that we are
obliged to lay open the putrid parts, by making scari-
fications through the dead and hardened skin, or so ma-
cerated by the fall of machinery, or by cannon-shot, as
to lie out a putrid and insensible mass, is a powder of
equal parts of Myrrh, Nitre, and Camphor, which should
be liberally strewed over the gangrened surface after
each fomentation.

Class IX.

I OF TONICS.

j We account tonics as not merely those medicines
|| which operate through the stomach, but various modes
of general excitement contributing to raise and sup-
j] port all the functions of the animal body in their
utmost vigour, or which, in other terms, maintain
, the re-action and tone of the living system. There
can be no ambiguity in the term ; whatever gives
permanent incitement, ensures regular vascular ac-
tion ; incited vascular action is followed in its turn
by increased exudation, which fills up the cellular in-
terstices, and by increased secretion, which augments

208 DEFINITION AND AlillANGEMENT OF TONICS-

the bulk of every fibre of the body. Increased nutrition,
secretion, and growth of fibre, bring an increase
strength and tone ; all the powers of the system are
kept in high action, and all the changes, both of nutri-
tion and absorption, are made to go on with still in-
creasing rapidity. ^

The usual excitements to animal feeling and action,
discreetly used, are tonics : Exercise includes almost all
of them : — Exercise is an excitement to vascular action,
the feehngs are exalted, the pulse rises, and from such
action a proportioned waste and absorption of the animal
fibre ensues ; from waste comes an increased demand for
nutrition, which I take to be, according to the laws of the
living system, a high excitement. Exercise then carries
with it exposure to air, and to light ; hilarity, and all the
excitement of spirit attendant on change of place ; a de-
mand for increased nutrition, and that increased arterial
action which secretes new fibre. These ordinary excite-
ments are tonics of the highest order ; they are universal,
natural, and capable of being continually augmented !
while partial excitements to the nervous system through
the stomach, assist in supporting those actions, and con-
stitute the class of medical tonics.

The arrangement, then, of tonics is easy, as their ope-
. ration is obvious. “ Tonics are such medicines as pro- <
duce a moderate and permaiient excitement:” First, '
Medicines operating solely on tlie stomach, aiding di-
gestion, and thence facilitating nutrition, as vegetables,
bitters, and acids : — Second, Tonics, or moderate stimu-
lants, affecting and impregnating the whole system, as
iron, and other metals : — Third, Universal and natural
excitements, as wine, food, air, exercise, cheerful com-
pany, the amusement of places of public resort, mineral
waters, riding, and country air and country occupations,

ABRANGEMENT OP TONICS. 209

cold bathing, and the cool air, during summer, of the
Highlands, or of the sea-coast.

The list, then, of tonic medicines need not be made
very burdensome to the memory, nor the research con-
cerning the individual substances very scientific ; the
chief indeed have been already mentioned.

Mineral Tonics.
Ferrum,

Cuprum,

Zincum,

Acidum Sulphuricum,

Nitricum,

* — Carbonicum.

Vegetable Tonics.

Gentiana,

Serpentaria,

Columbo,

Cinchona,

Myrrha,

Capsaria,

Sinapis,

Armoracea,

Rheum Palmatum,

VINUM, EXERCtTATIO, BALNEUM FRIGIDUM, FRIGOR
MONTIUM, VEL REGIONIS MARITIMI.

To these must be added, almost all those slighter
stimulant and pungent medicines, which we use as
vehicles in making draughts, infusions, or powders, as
CINNAMONUM, PIPERITA, ZINGIBER, CASSIA, CANELLA
ALBA, CALAMUS AROMATICUS, SEMEN CARUI, CARDA-
MOMi, CORIANDRI, MYRiSTicuM. Those are almost in-
variably combined with tonics, to which they contribute
little more than form, or a grateful taste. Tonics, then,
are again referred to one of those classes ; to steul and
BITTERS, ACIDS and METALS, excitiiig the stomach ; — to
mineral WATERS, Operating on the alimentary canal ;
-K)r to Wine, Diet, Exercise, and Cold Bathing, ope-
rating on all the sensibilities of the body, and all its
active organization.

VOL. IJT. fi

210

IRON AND ITS PREPARATIONS.

This class of medicines contributes rather to th(?
preservation than to the restoration of health. These
•medicines are not a cure for any one disease, because
there is no one organic affection, which they are suited
to cure ; they are given in thfe wane of all diseases, of
fever, dysentery, diarrhcea, cldorosis, &c. It is but to
prop up a debilitated, or animate a languid system, that
we prescribe this class of drugs ; and it is sad to think,
how much more frequently we are employed in prescrib-
ing bitter powders, and tinctm*es, with aromatics, which
approach so nearly to iilacehos, for the languid and hy-
pochondriac, than medicines of real efficacy in curing
disease.

Iron is perhaps the first of tonic medi- -i

cines, the most universally used, and the most confi- ^
dently. It is often used alone, and as frequently com- .
bined with all the other tonics, vegetable as well as mi-
neral. The carbonate of iron is the most usual form ; |j,
it is given in form of pill, powder, or bolus ; as a piU, or
bolus, made with confection of roses, it is given in doses t
of six or eight grains three or four times a-day. The f
bolus is often given with a few grains of ginger, and in |
this or any form, may be given to the amount of two i
drachms a-day, but not more, without producing sick- ^
ness. In powder, carbonate of ii’on is best combined ^
with an aromatic, or with magnesia : In electuary, often q,
with cinnamon, sugar, and supertartris potass^e, or in
bark electuary. I

The sulphates and muriates of iron, and the combi- I
nation of iron with ammonia, are still more active. The I
PERRUM AMMONiATUM is an irregular chemical com- i
pound of undecomposed muriate of ammonia with
lUURiATE OF IRON ; it is a preparation of which ten grains
may be repeated three times a-day. It has been chiefly •
celebrated in rickets, and is given combined with

OF COPPER.

211

RHUBARB every morning, with occasional purges in-
terposed, and occasional intermissions of a few days.
The SULPHATE OF IRON is a valuable form of the me-
dicine, and is very happily conjoined with neutral salts,
given in the morning, as mineral waters, or alone, or
with cinnamon, columbo, &c.

Tartris ferri is another valuable, be-
cause a veiy soluble preparation of iron ; it is the Soluble
Iron of the older pharmacopoeias, which, rubbed down
with sugar and oil of peppermint, makes an excellent
stomachic. The Tinctura Ferri Acetati, is the liquid form
in which iron is most frequently prescribed, thirty drops
or less being given in a glass of water three times a-day.

Iron prescribed in any of those forms, immediately
occasions foetid eructations, blackens the stools, quickens
the pulse, increases the secretions, and in no long time
improves the complexion. There can be no fact more
certain, nor any proof indeed of the tonic powers of iron
! more satisfactory than this, that ferruginous mineral wa-
1 ters are dangerous to those who are subject to disorders of
I the brain, especially to those who are subject to giddiness
' and slight apoplectic paroxysms, preceded by pulsations
of the temporal arteries; In such cases, preparations
i of iron are as immediately dangerous as external heat,
warm baths, or wine ; while they are in the same pro-
portion useful to those affected with pure paralysis.
Iron and its preparations, then, aggravate apoplexy ; oc-
! casion headaches and sickness ; force the return of ha-
bitual hjemorrhages ; and are therefore peculiarly dan-
! gerous to those who have disorders of the brain, or of
'■ the lungs, while they are universally useful in Chlorosis,
Amenorrhoea, Rachitis, Scrophula, jaundice, and dropsy.

' Cuprum, Copper, is a metal known more

I by its deleterious, than by its medicinal qualities, and
'too dangerous in my opinion for internal use. Its value,

o 2

£12

AMMONIARET OF COPPER. — ZINC.

externally applied, is indisputable ; but its exhibition
internally, was owing rather to a prejudice or whim of
the late Professor Cullen ; and it is rather mortifying to
those inclined to the use of this poison, that it is chiefly
trusted to in an incurable disease. Epilepsy ! while there '
is no evidence of its value in any curable disease. The <
only preparation of copper given internally, is the pill of
Ammoniaret of Copper ; and that I may not incur the
blame of expunging a medicine, obnoxious though it be, j
^and it is indeed as dangerous and as unavailing as any !
thing that can be named as a medicine), I shall explain
how it is to be used. The piUs are merely Ammoniaret t
of Copper with Crumb of Bread; they weigh three j
grains, and convey each half a grain of the medicine ; |
one pill is to be given twice a-day at first, viz. .a grain f
daily of the Ammoniaret, increasing the dose gradually (
till it sicken. This medicine is reported sometimes to j
have proved a cure for epilepsy.

Subacetate of copper, or Verdegrease, is an excel-
lent application to ulcers, especially of the nostrils, lips,
and tongue, or to cutaneous sores.

Zinc is a more harmless, but hardly a ;

more useful tonic. The pure oxide of zinc is given as t
a tonic in epilepsy, asthma, and other spasmodic diseases ; •
but I am persuaded with very little effect, and not with- j
out danger, for sometimes it operates as if it were taint- )
ed with arsenic or lead, contaminations which are so i
very likely, as to forbid our using it long, or in large j
doses. The oxide of zinc, calcined zinc, or, as it was
formerly named, flowers of zinc, is given in doses of six
or eight grains, up to the amount of half a drachm or
two scruples ; and the best form is to rub it down simply
with a little sugar.

The sulphate of zinc, which I have already mention-
ed as a quick emetic, is also, though rarely, used as a

OF GENTIAN. 213

tonic ; but its chief value is as an astringent in collyTia,
astringent washes, and injections for the urethra.

I do not think that we have tonics from the vegetable
kingdom as powerful as these.

Gentiana lutea. Gentian. — The roots

of gentian are long, tough, yellow within, and brownish
without, intensely bitter, with an aromatic flavour. This
is the purest a<id strongest of our bitters ; it is used as a
stomachic, — as a general tonic, though with power much
more limited than that of iron, — and as an anthelmintic.
It is chiefly prescribed in cases of mere Dyspepsia, in ha-
bitual debilities of the stomach or bowels, and in Bilious
disorders ; in cases especially of eructation, acidity, and
indigestion ; and it is especially useful in abating pains
of the stomach. Bitters are fashionable, and this, the
basis of them all, has become a favourite medicine. We
are apt to forget, that wine must be at once the best as-
sistant, as well as the fittest menstruum for stomachic
bitters, and that a vinous infusion should be preferred
to extract, or any other form. The tinctura genti-
ANiE composita is the most desirable form ; it is an in-
fusion of two ounces of gentian in two pounds of spirits,
j with the addition of orange peel and caneUa alba. This
may be taken in the proportion of a table-spoonful three
j times a-day, diluted with pure water, or with some dis-
tilled water, as Aqua Pimentae, &c.

A similar infusion, but in wine, we very often pre-
scribe as a more familiar medicine to be made by the
patient, and taken by wine-glassfuls, in which the vir-
tues of the gentian are usually combined with those of
Columbo and of Aromatics.

Watery infusions, too, are very grateful to the sto-
' mach, lighter, and in certain circumstances more proper ;
i the addition of a fourth part of spirits to the watery in-
j ^sion, both strengthens and preserves it : gentian, given

211

SERPENTARIA AND COLUMBO.

in great quantities, and in bilious habits, operates like
aloes on the bowels.

Aristolochia SERPENTARIA, hke gen-
tian and columbo, is a yellowish root, with a dark brown
envelope. It is a warm pungent aromatic bitter, which,
as already observed, is found cordial and anodyne in
low fever, and is most happily prescribed in combina-
tion with opium, or more particularly with camphor.

But as a stomachic, its warm pungent and stimulant
power makes it very valuable. It is lighter, more effi-
cacious, and every way preferable to bark, in the debi-
lity left by severe or lingering diseases. As a stomachic,
it is given in conjunction with iron, magnesia, pimento,

6iC. either in powders or in draught.

Colombo is the root of a plant imported

from Columbo in the island of Ceylon, and but little
known except by its virtues. It is hke the other aro-
matic bitters, a tough wrinkled root, yellow in its pith
or central part, brown on its skin or epidermis, shghtly
aromatic, somewhat acrid, and very intensely bitter. It l
is, like serpentaria, prescribed in fever ; but is infinitely ^
more valuable as an astringent and tonic in Cholera. In ;
the sick stage of low fevers it suspends the vomiting,
and procures sleep : in dysentery it is reckoned by many
a veiy specific ; its active principles are the same with
those of bark, its tonic powers infinitely superior. In
Cholera, febrile diarrhoea, dysentery, in the vomiting of
pregnancy, and in the sickness of fever : In languor, and j
debility of stomach, it is given like the other medicines '
of this class, in draughts : when we wish an immediate
operation, we give it in this form of draught ; but we
give it in powder, with magnesia, aromatics, cinnamon,
rhubarb, iron, &c. when we wish it to have more perma-
nent effects as a stomachic. j

CusPARiiE CORTEX, the Angustura Bark, !

OF MYRRH.

215

brought to us from South America, but lately intro-
duced, and commended as a specific in dysentery, is the
bark of a tree equally unknown with the former. It is
of a greyish-yeUow colour, intensely bitter, and with
little aroma. It is a warm and efficacious tonic in dis-
orders of the stomach and bowels ; is of exceUent use in
anorexia, flatulence, pain of stomach, and in short in aU
forms of dyspepsia ; and in diarrhoea is of peculiar ef-
ficacy.

Angustura is given alone, in doses of fifteen grains three

four times a-day, or in combination with carbonate
of lime, rhubai'b, iron, &c. The best vehicle is a glass
of cold water ; the most efficacious form, a simple pow-
der : A moderate dose of fifteen grains is found more ef-
ficacious than a heavy one. This is a medicine much light-
er on the stomach than Peruvian Bark, which, in large
doses, is very sickening and oppressive ; and let it be re-
membered, that though Peruvian Bark takes precedence
of all others in intermittent fever, angustura, columbo,
serpentaria, are all preferable tonics. An infusion of
angustura is so feeble, as to be little better than a mere
placebo, which is indeed the undisguised, right, honest
term for aU your “ light infusions of bark,” &c.

Myrrha, Myrrh, is a reddish-yellow odo-
riferous gum, of unknown plants brought to us from
China, and Cochin-China, in the form of big tears or
drops. It is produced in Ai'abia and Abyssinia, and pe-
culiarly prized all over the East, for its uses as a per-
fume, and in embalming dead bodies. It is a strong
and powerfully aromatic bitter gum, which is very per-
fectly soluble in alcohol, forming a pure transparent tinc-
ture, but also in water, whence it melts entirely in the
mouth.

Myrrh is a warm stimulant and tonic medicine, which
invigorates all the secretions, and especially promotes the

216

OF PURGES AS TONICS.

uterine discharge. It is usually given in powder with
steel, as formerly mentioned, or in pill, in doses of fifteen
or twenty gTains three or four times a-day ; or a drachm
of the tincture may be given either in combination with
other stomachic bitters, or with peppermint- water. This
is the least unpleasant, the warmest and most cordial of
bitters : it is a medicine too little used, except exter-
nally for washing sores, or injecting sinuses, or strength-
ening the gums.

I cannot allow myself to close this Section on Tonics,
without mentioning purges as the most valuable. Some no
doubt feel as i^ frequent purges were a sort of poison, the
intestines being kept in an irritable condition, and the
stomach sickly ; but this is far from being the usual ef-
fect. If heavy doses of bark, of steel, of columbo, &c.
be given in any disease, the interposition of purges is
essential ; and in all circumstances, a brisk purge, given
from time to time, and followed on the evening of the
same day with a cup of warm wine, or wine whey, in-
vigorates the appetite, brings on a keen and healthy
action of the absorbent and vascular system, and favours
any tonic course of medicines. This effect of purges
best explains the happy operation of mineral waters, in
strengthening languid health.

Aromatics, in so far as they are medi-
cinal, are tonics, and are justly ranked under this deno-
mination ; yet there is little reason to detain readers of
even the most moderate information, witli botanical his-
tories, of Peppennint, Ginger, Cassia, and Canella, Clove
gillie-flowers, and Oranges. When he finds these ai’o-
pnatics in any receipt, he can hardly be at any loss to
divine the intention of them ; tlie chief design must al-
ways be, to make the draught more acceptable to the
taste or_stomach : they are merely vehicles.

THEORY OR ASTRINGENTS.

S17

Class X.

OF ASTRINGENTS.

It must appear at the first superficial view, that the
class of astringents cannot be very important, and that
the word astringency, and astringent, implies a slight
^d topical effect. But under the Tittle Astringents, we
are called upon to class all those valuable remedies which
have an influence in moderating increased discharges, — an
influence more important often towards saving the life of a
patient, than that even of the medicines adapted to allay
nervous pain, or suspend vascular action. — Profluvije,
INCREASED DISCHARGES, whether hjemorrhages from the
internal surfaces of the body, or effusions of serum and of
mucous secretion, together with those irritated motions
which hurry along the nutritious parts of our food, un-
concocted, through the alimentary canal, are among the
most dangerous, whether they occasion the nutritious
substances to run to waste, through profuse discharge,
or prevent nourishment being assimilated or absorbed.

There have been very idle debates about the exis-
tence of universal astringents ; and an opinion has been
I propagated, chiefly by the celebrated Dr Cullen, that
I astringents applied to the stomach or surface, may, by
j a sort of sympathy, and througli the medium of the
I nerves, have an influence even upon the most remote
j parts of the system, Tliat an astringent medicine, ap-
I plied to the stomach, or to the surface, or in any ima-
! ginable way, should have the effect, by sympathy, of
: constringing the exhalent arteries on the surfaces of the
throat, of the lungs, or of the womb, is a thing so in-
I credible, that if such a fact were proved, we should be
at a loss to conceive liow so singular an effect was pro-
i duced. But in tnith, we have uo reason, either from.

218

PROFLUVUE AlCn HEMORRHAGES

experiment, or from observation in disease, or from ana- ^
log}% to believe the fact. We must resort to other prin- ;
ciples for explaining the influence of medicine, in stop-
ping haemorrhages and profuse discharges. This, of an ,
astringent power, propagated by sympathy, is widely
different indeed from any thing that I should have
imagined.

Hsemorrhages and Profluviae, or increased discharges,
depend surely upon the mechanism of the part, and are
consequences of vascular action excited to an intense de-
gree, in delicate internal surfaces, or in secreting mem-
branes. Profluviee, or fluxes of mucus, of serum, or of
mixed and anomalous matters, are the mere consequence
of intense arterial action, dilating the extremfe arteries ;
and no one can be at a loss to perceive how and why
this happens, who has ever injected the dead body ; for
while the injection, driven with its colouring matter
through the larger vessels, remains in them, and fills f
them, the finer parts exude from every surface, ema-
nate in small gouts from all the internal surfaces, and
if pushed hard, stream out from the nostrils, the sur-
faces of the throat, of the lungs, of the intestines, of the
hi’ain, &c. The phenomena of a common cold explain
the mechanism of the animal body ; for the patient (
weakens in the morning before his paroxysms of cough- (
ing come on, with the nostrils dry, and the Schneiderian 1
membrane no way swollen nor inflamed ; but in five mi- I

nutes the violence of coughing, arising distinctly from (

irritation of the larynx, so injects the head with blood,
that the very brain is oppressed, the head is confused,
the sight obscured, and the serum streams profusely
from the nostrils, as water exudes when injected through
the cai'otids. j

Haemon’hages are what inflammation should be in I
the same cucumstances. Inflammation is intense action f
of vessels in parts where there is no outlet for that efiu- i

I

arise from incited action. 219

sion, whether serous or bloody, which must ensue, ex*
cept the cellular substance or solid structure of the part !
Haemorrhage is intense arterial action on surfaces so de*
licate, that the extreme vessels give way, and blood is
poured out into the trachea, the stomach, the rectum,
the cavity of the uterus, or whatever organ is affected.
Profluviae, or increased discharges, are excited vascular
action on those surfaces destined to secrete the useful
fluids, but which, when the structure is forced, and the
extreme vessels dilated, pour out not a natural or ma-
ture secretion, but a thin, serous, pungent fluid, often
mixed with blood, as in catarrh, dysentery, gonor-
rhoea, and FLUOR albus. From this induction it is
obvious, that the best and the only general astringents,
are those which suspend vascular action ; and that it is
only in hollow tubes, through which we can freely pour
what may be called external applications, that we can
have the benefit of what are truly Astringents ; for there
are, as we shall presently explain, many remedies which
have this direct effect of astringency upon the animal
fibre, as manifestly as upon dead matter, and probably
I through the same chemical affinities.

It will require no ai-gument, but the spontaneous
' conviction arising from experience, to confirm this view
of the subject ; when we recollect how we have leai'nt
j from experience to treat those diseases, we perceive that
! this is the simple truth. It is indeed natural, upon
observing the phenomena produced by cold on the
; living body, viz. its corrugating the scrotum, contract-
ing the skin, expelling the blood from the extreme ves-
sels, causing universal paleness, and arresting hasmor-
rhages, to ascribe these phenomena to the astringent
power of cold, and to rank cold as the most universal
astringent. In like manner, ipecacuanha moderates, in
^ remarkable degree, uterine hfemorrhages, ahdne fluxes.

I

220

ARRANGEMENT OF ASTRINGENTS.

and pulmonary discharges ; and this is denominated a i
new property! an astringent power I when all the while

COLD, IPECACUANHA, BLEEDING, NITRE, ACIDS, OPIUM,

ah that we prescribe in haemorrhages and profuse dis-
charges, are merely sedatives, moderating the vascular
excitement in the diseased surface, and the sensibilities j
of the whole frame *, and haemorrhages and profluviae are,
upon surfaces, the result of that incited action, which,
within the surfaces of the skin, or in the substance of
the various organs, would cause exanthemata, erysipelas,
swellings from effusion, inflammation, and suppura-
tions.

Astringent medicines must be strictly defined,

** Such as, being immediately apphed to vessels either
actually forced and burst, or merely dilated, so as to pouf
forth actual blood, (or a profusion of lymph or serum,
or a diseased secretion, often tinted with blood), coN-
STRINGE and close them.” But in the general relation
of medicine to such diseases, it is necessary to take a
more liberal and general view, and to class together aU
medicines, useful in profluviae, genei-al as well as to-
pical.

1st, General remedies in haemorrhages and pro-
fluvia?, are such as moderate vascular action ; and those ,
especially useful in this order of diseases, are, emetics,
COLD, mineral acids, NITRE ; to wliicli must be add-
ed, Bleeding, Digitalis, Opiates, and Purges, which are
beneficial in haemorrhages even of the bowels, and bleed-
ing useful in all hamorrhages : though, of the benefit of
this universal remedy, humanity was nearly deprived, and
actually so for a time, by the low ridicule, and surly, i
impudent dogmas of the brunonian school.

2(7, There is another order of astringents allied with
these, in so much as they are beholden more to their |

effects as sedatives, than to their direct astringent power. 1

OF DIEECT AND ACTUAL ASTEINGENTS. 221

Alvine fluxes proceed as much from continued irrita-
tion, and muscular excitement, as from vascular acticai,
or increased secretion; and in these circumstances,
earthy medicines, which neutralize the acid, (and are
thence named Absorbents), and opiates, which at once
allay the sensibility of the surfaces, and subdue muscu-
lar contraction, are the best astringents, for so they are
named and used, although, like cold and emetics, de-
void of any real astringent power. This order includes
OPIUM, cakbgnas calcis, gum, mimosa nilotica, &e.

3d, There is an order of medicines truly and di-
rectly astringent, which, being applied to the diseased
surface, or haemorrhagic vessels, constringes them ;
and this valuable class of astringents is in daily use in
all kinds of diseases, both internally, where tJieir as-
tringent powCTs can act directly, as in Haematemesis, or
vomiting of blood ; in Mekeua, or morbus niger ; in
Cholera morbus. Diarrhoea, and Dysentery 4 in Menor-
rhagia, Leucoirhoea, and Gonorrhoea : Also in external
disorders, as Ophthalmia, Ulcerations, Sores, Fistulas, Po-
lypi, ulcers of the throat and nostrils, piles, and other
disorders of the verge of the anus.

Astringents, whether derived from the mineral or
•vegetable kingdom, owe their power to one of two
principles, viz. Acid or Tannin ; and these corrugate the
parts of living bodies, probably by the same chemical
property that operates on the dead, viz. by affecting the
animal gelatin. Of acids, the Nitric, Sulphuric, and
^luriatic acids, and Alumen ; — from the vegetable king--
dom, the Acetous and Gallic acids, are powerfully astrin-
gent ; and these are used chiefly in h£emorrhages.-‘-Eut-
of vegetables, the astringency is proportioned either to
the prevalence of the tanning principle, or of gallic acid,
or theit proportions to each other, and to the inert vege-
table matter; for both principles of astringency are

22^ OF THE VARIOUS USES OF ASTRINGENTS.

combined in almost all vegetable astringents. The ve-
getables in which these two astringent principles are
found most to abound, and in which their existence is
announced to us by their taste, and action on the tongue,
are. Galls, Oak-Bark, Columbo, Catechu, Simarouba,
Serpentaria, Rose Leaves, &c. ; there are, indeed, few
vegetables entirely void of this property.

Perhaps a slight concluding sketch of the various uses
of astringents, in the several orders of external and in-
ternal diseases, may have its use in practice, especially
to the young and inexperienced.

First, In general haemorrhages, where we have it not | '
in our power to apply direct astringents, as in haemor- ,
rhages from the lungs, trachea, kidney, &c. we rely '

chiefly on sedatives and narcotics, as they are described ‘

in their respective classes, and especially on cold, eme- '
TICS, BLEEDING, PURGING, ACIDS, as Well Vegetable as '
mineral, viz. vinegar, sulphuric acid, nitric, and muriatic,
NITRE, SALINE DRAUGHTS, OPIATES, DIGITALIS. ‘

Second, In hasmorrhages from surfaces, which, though *
internal, can be reached by the direct astringents ; in ^ ‘
Hasmatemesis, or vomiting of blood from the surface of \ ‘
the stomach ; in IMelaena, morbus niger, or black purging ‘
of scurvy, or of malignant fever, where the blood exudes
upon the internal surface of the bowels ; in Menorrhagia,
or excessive menstruation; in Abortion, and in Child-Bed
Flooding ; in Epistaxis, or flow of blood from the nos-
trils ; in those dreadfid haemorrhages which accompany j
Polypus of the nostrils and vagina ; the vessels may be
constringed, (besides the general remedies just men-
' tioned, of sickening doses of emetics, bleeding, and cold),
by giving liberally of dilute sulphuric acid, of alum, of
vinegar, &c. joined with infusion of roses, oak-bark,
gum kino, &c. ; or by injecting dilute acids into the nos- |
tills, vagina, and uterus.

OF SLIGHTER EXTERNAL ASTRINGENTS. 223

Third, In alvine fluxes, accompanied with pain, fever,
and muscular irritation, our course of medicines is di-
rected first to soothe the surfaces, to assuage pain, and
gradually to constringe the vessels and glands, which
pour out their lymph too profusely. — Here acids can
hardly be allowed a place : the first medicines are.
Opiates and Absorbents, the second, slighter and merely
vegetable astringents, as oak-bark, logwood, cate-
chu, GUM-KINO, COLOMBO, SERPENTARIA, CINNAMON,
RHUBARB, PERUVIAN BARK, ROSE LEAVES. These are
' the medicines used in Dyspepsia, Diarrhoea, Dysentery,

I and Cholera Morbus.

Fourth, A long and valuable order of astringents, is
j that of medicines which prove slightly stimulating and
astringent in the disorders of hollow passages, especially
in serous and mucous fluxes ; in diseases of the urethra
and bladder ; in fluor albus, or serous and mucous effu-
sion from the surfaces of the vagina and womb ; in sores
i of the nostrils or throat ; in polypi, &c. or in external
i sores. And here we return to the saline astringents, and
j chiefly to combinations of the sulphuric and vegetable
acids with various metals, or combinations of metallic
, salts with vegetable astringents ; acetas plumbi, sul-
’ phates of ZINC, IRON, and copper ; vinegar, wine,

; TEA, INFUSION OF OAK-BARK, ARBUTUS UVA URSI, &iC.

I These are the chief of this class ; and the same medi-
cines are applied sometimes in the form of watery solu-
I tion, sometimes of ointment, sometimes of dry powder,
I to external ulcers, to eruptive sores, to ophthalmia tarsi^
! to large, flat, and gleeting ulcers, which are indeed in
j a condition little different from that of hasmorrhagic
i surfaces.

224<

ACTETAS ?LUMBt DAN(i£EOUS.

I

LIST OF ASTRINGENTS.

MINERAL.

VEGETABLE.

Super-Acetas Plumbi,

Opium,

Acidum Sulphuricum,

Acetum,

Super-Sulphas Aluminae et

Quercus,

Potassse,

Gall®,

Sulphas Ferri,

Catechu,

Cupri,

Kino,

Zinci,

Arbutus Uva Ursi,

Oxidum Zinci,

Columba,

Carbonas Zinci,

Serpentaria,

Cdcis.

Simarouba,

Cinchona,

Rosa Gallica,
H®matoxylon,
Rheum Pahnatum.

SuPER-ACETAS PLUMBi. The oxide of

lead, super-saturated with the fumes of acetic acid, then ,
dissolved in vinegar, and crystallized, is a white, sweet, i
astringent salt, drawing together the lips, and affecting
the organ of taste with a sensation strongly resembling -
that communicated by alum. Lead is at once a deadly
I sedative poison, extremely insidious, affecting the health

; (in those who work in lead) for years before it produces *

1 palsy : Its effects are, emaciation, paleness, a sickly ha- -

' bit, feebleness, loss of appetite, pain of stomach, cori- •

i stipation, frequent colic, and at last palsy.

Super-acetate of lead was used internally for the cure f
^ of phthisis ; and no doubt it were a strong apology for i

the cautious use even of this insidious poison, if it liad 1

; any real influence in a disease so invariably fatal. But the '

4 use of such a poison arose from a passion and pride that

i

i

'i

l!

OF ACETATE OF LEAD>

S25

vailed some years ago, in prescribing the most delete-
rious poisons, safely at least, if not successfully. This
course of experiments was continued long enough to
enlarge the bounds of the materia medica, and to dis-
tinguish this particular poison as one for ever to be
avoided. I know no man who would now be so
fool-hardy or daring, as prescribe the Tinctura Anti-
phthisica, as it was called, or solution of lead.

Externally applied. Acetate of Lead is an invaluable
medicine ; it is used continually as an astringent and
cooling solution, of the strength of a drachm to the
twelve ounces, when dissolved in distilled water; a
drachm to ten ounces, when common water is used ;
or, if it is required of gi-eater strength, a spoonfiil of
common vinegar is added to aid the solution. — In the
form of solution, it is the astringent most approved in
external inflammation, in burns, in cutaneous sores, in
ophthalmia ; it is also the best injection in fistulas, run-
nings of the ears, diseases of the nostrils, gononfioea in
the male sex, and sores and runnings of the vagina.

The Super- Acetas Plumbi, or Sugar of Lead, as it is
named, is mixed uuth wax and spermaceti in ointments ;
but any metallic preparation so involved loses its eflect.
The pure or white oxide of lead, Cerussa, Oxidum
Plumbi Album, is one of the most precious applications
for rebellious sores ; and if this dry powder, mixed with
carbonate of zinc, were as familiarly used as ointments
are, I believe sores would be comparatively of very
short duration. This powder I very invariably use for
the dry dressing of extensive cutaneous sores, ulcerated
buboes, &c. ; alternating this drying and astringent
powder with fomentation or poultice at night.

Acidum sulphuricum. The sulphuric

acid is made perfect for commerce ; its chemical proper-
ties are to be learnt in books of chemistry : there is no

VOJ,. TIE r.

226

OF SULPHURIC ACID.

occasion for a pharmaceutical history of sulphuric acid.—'
The styptic properties of all mineral astringents result
from their combination with acids, as in the sulphates
of Iron, Copper, Zinc, and Argilla ; but the acid itself,
pure and uncombined, is, especially in haemorrhages the
most useful of all astringents, and can be given in great
strength internallj^ being diluted. — It is useful, though
much diluted : When the solution is to be used very

strong, it is to be taken, by sucking it up through a
glass tube, or through a quill, that it may not set the
teeth on edge.

In Hsematemesis, or vomiting of blood, flowing
from the veins and arteries of the stomach ; and in Me-
loena Morbus Niger, the black stool of infectious, or as
they are termed, putrid fevers, it is a medicine by
which we very often save the patient’s life ; often I
have seen many pints of blood vomited, and the pa-
tient reduced to extreme debility, yet the haemorrhagy
instantly stopped, and the patient restored to feeling
and strength, by a few doses of sulphuric acid. — In all
other Haemorrhages, as Haemoptysis, Menorrhagia, &c.
when it cannot directly affect the vessels, it is (though
always and very properly prescribed) merely cooling and
sedative.

The dilute sulphuric acid is the form in which it is
most frequently prescribed, in doses of fifteen or twenty
di-ops three or four times a-day. The official prepara-
tion formerly termed Elixir of Vitriol, now acidu.m
SULPHURICUM AROMATicuM, is a mixture of sulphuric
acid with alcohol, poured upon ginger and cinna-
mon, and digested for two days; the preparation of
course partakes of the aromatics, and so far is a sto-
machic, and by the digestion of the sulphuric acid
with alcohol, is allied with the cetherial spirits, a sort
of spiritus vitrioli dulcis. And although the dilute
sulphiu-ic acid is preferred in hasmorrhages, this is pre-

SULPHATES OF ALUM, IRON, kc. 227

scribed in dyspeptic complaints, or as a general astrin-
gent and tonic, thirty drops being given in a glass of
water three times a-day.

— ^ — — Supersulphas alumin^e et Potassas, is
but another form in which we use this acid ; it is an
earthy saltj a supersaturated solution of alum, with a
small proportion of potass, extremely acid^ and painfully
pursing up the tongue and lips. — It is less frequently
used internally, but as an external astringent is conti-
nually prescribed, in injections, gargarisms, collyria, and
all astringent solutions. It is most especially useful as
a gargle in relaxation of the throat, and still more as a
means of suppressing the more dangerous hcemorrhages
from the womb. — In haemorrhages, especially those from
the stomach or the bowels, it may be given along with
powder of gum-arabic, cinnamon, kc, in doses of twenty
grains every hour. Alum has been the basis of all the
vaunted secrets for stopping hsemorrhagy : The pul vis
STYPTicus of the pharmacopoeia, is four pails of sulphate
of alum with one of gum-kino. But I think Tve may
venture to assume such a degree of improvement in sur-
' gery, as to hope, that styptic powders will never more
be in request. ^

Sulphas feIiri. The Green Sulphate of

Iron, (green vitriol), is a styptic of another kind : it is
^ not in haemorrhages, nor in haemorrhagic diseases, that
this medicine is used, but in relaxed conditions of the
primae via? after severe diarrhoea or dysentery ; after
dropsy, to restore the tone of the viscera, or after inter-
mitted or low fever. A grain in a boy, or two grains
or three in an adult, may be given in a powder, after
each dose of bark ; or two grains or three may be given
every morning along with a gentle dose of neutral salts,
operating in the manner of a mineral water.

' The sulphas cupri, which has a very strong.

p 2

228

SULPHATE AND OXIDE OF ZINC.

astringent, metallic taste, is so dangerous, so dreadful an
emetic, almost a poison, even in the most minute doses,
that I pass it by willingly, under protest, to take notice
of that metallic astringent wliich we prefer to all others,
especially for external use.

Sulphas zinci, white vitriol : The eme-
tic property of sulphate of zinc has been mentioned ; its
use as an internal medicine is indeed very limited.
Zinc is not given as an established medicine in debility of
stomach, diaiThoea, &c. but Zinc is commended by indi-
viduals as a medicine whicli they have found useful, either
in form of oxide or of sulphate, in those agues which, in
warm climates, have resisted the usual medicines ; and is
prescribed sometimes in pills of oxide of zinc, two grains
repeated three times a-day, or of solutio sulphatis zinci,
conveying four grains three times a-day.

But the unequivocal use of sulphate of zinc, is not so
much in external inflammations, as in the diseases of
mucous membranes, especially those of the Eye-lids,
Urethra, and Vagina ; in this sense it is a very pre-
cious medicine. The Oxidum Zinci Impurum, the
I.«apis Tutia?, has been long known and valued as a
harmless and effectual astringent ; in ophthalmia it is
the basis of many ointments ; in slight ulcerations
of the skin, in burns, and in sciildings in the groins,
and behind the cars of children, and in tinea capi-
tis, applied dry as a powder, it is of great use : So is
the more cleanly pre])ai’ation, the carbonas zinci. La-
pis Calaminaris, which, from its reddish colour, espe-
cially when mixed witli oxidum plumbi album, is a
. cleanly and most valuable preparation in herpetic ulce-
rations, being of the colour of the skin, and thence little
conspicuous.

The solution of sulphas zinci, in various proportions
suited to the exigencies of the case, is the most valuable
medicine as a collyrium : in gonorrhoea, also, and in fluor

CARBONAS CALCIS.

229

albiis, a disease infinitely more frequent and distressing
than the modesty of women permits us to know, and which
is followed by the most vexatious and harassing of all
female complaints, a prolapsus vaginae and procedentia
uteri. Alum, sulphate of zinc, and camphor, aie often
combined, and with the best effects, as stimulants and
powerful astringents.

— , — Carbonas CALCIS. — The Carbonate of
Lime, chalk, or crabs eyes, viz. the chalky secretion
found on each side of the stomach of the crab, is a me-
dicine of great efficacy in disorders of the bowels, accom-
panied with acidity of stomach, and often arising, es-
pecially in children, from the abundance of vegetable
acid, which requires to be neutralized. — Chalk, in
itself perfectly harmless, is to be given in no limited
dose nor form, but in quantity proportioned to the pain,
eructation, irregular diarrhoea, and other marks of aci-
dity. In the diarrhoea of infants it is almost the only
medicine required, and forms, when suspended with
mucilage in common water, and sweetened with syrup,

I a very pleasing and useful astringent : for children, sy-
rup of poppies, or in other terms, the addition of a few
drops of tinctura opii, is conjoined : in the diarrhoea of
adults, and in that dysentery in which we have no rea-
I son to fear the retention of Scyballse, or hardened feces,

I a julep of chalk, with laudanum, cinnamon, and some

I aromatic, is very useful. Among the poor, chalk should
be given in great quantity : — Then* weakly children, feed-
!' ing on uncooked vegetables, and dying of diaiThoea, re-
I quire frequent doses of the compound powder of chalk,

, ; with opium, or equivalent extemporaneous prescriptions.

— Mimosa catechu, is not Japan Earth,

r (Terra Japonica), as formerly named, not any way al-
\ lied to earthy substances, but the inspissated juice from
9> Mimosa peculiar to the higher provinces of Ben-
gal. It is suspected to be extracted from a variety of

330

KINO.

woods ; it is of an earthy appearance, dry and brittle, in
small granular masses like half-dried clay: It melts in the
mouth ; its taste is bitter, with a remaining impression
of sweetness and astringency; and from its chemical
qualities of striking black with solutions of iron, and
forming a precipitate with any gelatinous infusion, it
plainly contains both kinds of astringent principle, tannin
and gallic acid. — It is warm, cordial, strengthening, and
astringent ; and though used in haemorrhages and proflu-
via, where it can be of no seiwice, as in haemoptysis and
catarrh, &c. it is truly valuable in disorders of the sto-
mach and bowels, especially in long protracted diarrhoea,
in dysentery, and in general debility of viscera.

The Electuarium Catechu is not, like the Alexiphar-
macs of old, an unmeaning jumble of all kinds of spices
and stimulants, but a very precious and perfect forai for
exhibiting this medicine in combination with opium, to i
increase its efficacy in complaints of the bowels, and of i
cardamom seeds, cloves, and nutmegs, to warm and sti-
mulate the stomach. But it is not to be forgotten, that
in extemporaneous prescriptions, this electuary is to be
reinforced by the addition of carbonas calcis and tine- i
tura opii. The confectio aromatica is a preparation 1
of carbonas calcis and opium, that may almost come in
competition with the Electuarium Catechu : half a tea- i
spoonful, a scruple or more, of either of these, may- be
given from hour to hour ; or they may be mixed in
form of julep, with infusion of roses, and suspended by
mucilage.

Kino resembles the astringent last described

in all points. It is, like it, an inspissated extract, from
the wood probably of an African plant ; like catechu, it
blackens solutions of iron, and precipitates the gelatine
from a solution of isinglass ; It has a brittle texture, an
insipid but bitterish taste, terminating in sweetness, and

KINO, IPECACUANHA, AND RHUBARB.

S31

with manifest and strong astringency : It melts in the
saliva, is easily dissolved, makes a transparent dark-
brown solution, whether with alcohol or water, and has
been always reckoned, and is truly, a powerful astrin-
gent

The astringent power of Kino, combined with the se-
dative power of opium, forms a medicine of incompa-
rable efficacy in the diarrhoea of debilitated constitutions,
in the diarrhoea especially of ill-nursed children, or of
the aged and infirm... — The pul vis kino compositus of
the London Pharmacopoeia, is a compound of Kino, Cin-
namon, and Opium, each scruple conveying one grain of
opium. This medicine is esteemed a useful remedy as
a general astringent, useful of course in hoemorrhages
and uterine discharges : If it be so, it is only as a tonic,
as restoring strength to the stomach and bowels ; I have
found it useful only in diseases of the intestines.

Ipecacuanha. The power of this medi-
cine in stopping all inordinate actions, especially those
of the alimentary canal, is already sufficiently explain-
ed. Its use, given in small doses of a grain three times a-
day with carbonas calcis, and the invaluable combination
of it with opium, or the pulvis ipecacuanha compositus,
has also been explained. A few grains of this powder,
conjoined with aromatics, and given frequently during
the day, is one of the most commanding medicines in
dysentery.

Rhubarb, while it is a purge, or laxative

rather, is manifestly astringent ; its sweetish and astrin-
gent taste sufficiently evince that precise quality which
we wish to find in a slight stomach astringent, fit to re-
store the tone of the stomach in adults, and to restrain
diarrhoea in childi-en. For the former purpose, it is best
taken in powder, in doses of ten or fifteen grains in the
morning: doses which, in the adult in tolerable health and

232 OF LOGWOOD. — WHORTLEBEERY.

action, do not affect the bowels ; or to a cliild, it is given j
mixed with Potio Cretacea. '■

Hcematoxylon campeciiianum. The

Logwood Tree, as used by the Dyers, is a gentle, not
impleasing, and yet effectual astringent, fit especially to
be prescribed in the Lienteric Disease, and lienteric
weakness, or defect of digestion, and occasional disorder
of the bowels, which often survives acute dysentery. A '
course of this medicine, is as useful in strengthening the
bowels as a course of serpentaria or columbo. Jjogwood
chips, when chewed, give out that sweetish astringent
taste which boys delight in ; and when boiled strongly,
the juice inspissated, gives an extract full of the virtue
of the wood. — A decoction of the ivood I think most ef-
ficacious ; it is made by boiling two ounces of logwood
chips in two pounds of water, till it is boiled down to
one pound ; two thirds, or the vdiole, may be taken in
the day. If the extract is preferred, it may be given
soft, to the extent of half a drachm repeated frequently
during the day, or in form of a draught.

Arbutus uva ursi. Folia. The Whor-
tleberry is a low-gTowing laurel-like shrub, with an un-
pleasant bitter taste and manifest astringency ; whence '■
it is actually used, especially in Russia, for tanning. As
an astringent, especially in uterine hcemorrhages, it was

much used on the continent : De Haen, in lack of

more effectual medicines, for the cure of ulceration of
the bladder, (a disease for which I fear there is no
cure), thought fit to prescribe this as a sole and sovereign
remedy, till at last he persuaded himself, and half per-
suaded others, that it was actually efficacious in this de-
sperate and melancholy disease. — It is always to be recol-
lected, that when we know of no efficacious remedy, we
are ready to assent to any, however unavaihng! just as our
patients, when disappointed of success under the care

OF OAK-BARK AND GALLS.

2S3

of pliysidans, abandon themselves to quacks. The san-
guine hopes of finding this medicine a cure for ulcera-
tion of tiie bladder, and even an anodyne for the pains
of the stone, inspired by De Haen’s unreserved enco-
miums, has survived even to the present day. But I be-
lieve our profession is now pretty weU persuaded of the
opinion I have professed, viz. That astringents can
hardly have power on any organ or set of vessels to
which they are not directly applied ; accordingly, pills
of Hyoscyamus and Cicuta, mere anodynes and nar-
cotics, are prescribed universally in preference to the pills
or powders of Uva Ursi, unless it be that Astringents
are sometimes assented to as moderating the diarrhoea,
or curing the dyspeptic and gouty symptoms which
usually accompany nephritic complaints and stone. This
is the last of the astringents used internally, the oak or
willow are chiefly used as external astringents.

Quercus robur, cortex, — ^the Oak-bark,

Quercus cerris. Galls, the excrescence from the oak,
are certainly the most powerful of our astringents. — The
former, the Oak-bark, (together with the leaves or the
eup of the acorn, used in tanning), powerfully co-ope-
rates with Alum Kino, and other astringents used exter-
nally ; the Gall-Nut is an exudation produced by the
punctures of insects : The insect cynips quercus, pier-
cing the bark, or entering the leaves or stalks, becomes
involved in the exudation, which assumes a spongy, globu-
lar, berry-like form, and, in process of time, the insect eats
its way out. — This is a powerful astringent, too power-
I ful to be used internally. The bark-leaves and acom-
I cups are used in tanning, the gall-nuts in making ink ;
i and each contains, in great profusion, both the prin-
I ciples of astringency, the Tannin and the Gallic Acid.

■ Oak-bark it never is possible to use internally : Its
' - styptic taste is strong, its bitter not so intense: It has

234. COMBINATIONS FOR ASTRINGENT INFUSIONS.

been used as a substitute for the Peruvian bark, and
unquestionably cures intermittent fever, with this un-
avoidable inconvenience, that it constipates the bowels.

It is too difficultly reduced to powder to be given in
that form : it is better used in form of decoction, an
ounce of the bark-leaves or acom-cups to a pound of
water : If the powder is given, let it be of the acom-
cups ; some choose to give half a drachm of this three
or four times a-day ; or the roasted acom-cups they give
boded, and mixed like coffee, in doses from one to three
drachms, in debility, diarrhoea, fever, or intermittent, as
a succedaneum for bark.

Its EXTERNAL USE is in relaxations of parts which
can be injected or bathed with a decoction, simple or
combined, as in prolapsus ani, prolapsus vaginae, and fluor
albus in females, and in inveterate gleet in the male sex :
It is also sometimes used as a gargle, in relaxation of the
uvula and tonsils. — Such astringent fomentations or in-
jections may be made in the weaker degree by infusion
of the powdered bark, with hot water, shaking or stirring
it occasionally, or by suspending a bag of powdered oak-
bark in wine. For gleets, a stronger preparation is made
by boiling it in \vine, and adding alum, a preparation
which is also useful in Procedentia Vaginas vel Uteri ;
and in Leucorrhoea, which is most commonly the cause
of this wretched, irritating disorder, the Procedentia or
Descent of the Womb, it is equally useful : For Leu-
corrhoea, bark infusion is often usefully combined with
lime-water.

Gall-nuts. The excrescences formed as

nuts around the insect which punctures the bark and
leaves of the oak, (Cynips Quercus), is the most powerful
of vegetable astringents, holding its virtues both from
the tanning principle and gallic acid. Its infusion is
found to be the most powerful astringent ; and the pow-

aqua calcis,

235

der of galls, mixed with axunge, is found to be the
most efficacious astringent in corrugating the relaxed
rectum, and constringing piles ; for the same purposes,
a watery infusion is very efficacious.

One astringent more, used both externally and inter-
nally, must not be omitted, — ^aqua calcis. Lime Water.
It is formed by saturating water with the lime ; and the
water so saturated must be well corked, to preserve it
from imbibing carbonic acid from the atmosphere. — It
is transparent, colourless, hot, pungent, and manifestly
astringent ; it corrugates and shrivels up dead animal
matter, and constringes the li^g fibre. From possess-
ing at once astringent and absorbent, or neutralizing
powers, it is peculiarly useful in dyspepsia, diarrhoea,
and all debilities of the stomach and intestines. It is
used internally, in the quantity of a pound or more
a-day, mixed with an equal quantity of milk, in fluor
albus, &c. But its best use is as an injection in leucor-
rhoea, procedentia uteri, prolapsus ani, &c. ; and as a
wholesome stimulant to ill-conditioned sores and exten-
sive ulcers.

As all astringents are resolved now into external ap-
plications, I trust that all possible varieties will be found
among the Extemporaneous Prescriptions, and will be
intelligible; being, — First, Astringent Lotions; — Se-
cond, Collyria; — Third, Gargarisms;- — Fourth, Injec-
tions-,i — Fifth, Powders; — Sixth, Ointments.

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PHARMACOPCEIA.

PART SECOND.

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PHARMACOPCEIA

1

PART SECOND.

i

! OF

j

i EXTEMPORANEOUS PRESCRIPTIONS.

I JfUST now remind my reader, that all the apparatus
I of the Materia Medica has for its object, the preserving
I or restoring the healthful actions, and pleasant feelings,
natural to the animal frame ; and that the various orders
I and classes of medicine preserve and restore health, chiefly
by one or other of these operations, — First, by subduing
inordinate action : — Second, by deadening the sensibili-
ties of the animal frame : — Third, by increasing and pro-
moting the necessary evacuations, and natural secretions :
— Or, Fourth, by exciting and maintaining, by stimu-
lant and tonic medicines, the perfect action, and health^
fill feelings, of the whole system.

Class I.

OF SEDATIVES, OR REFRIGERANTS.

The medicines we are now to describe, are useful
sometimes in extreme sensibility or pain> but chiefly in

240

t)F BLEEDING.

incited vascular action, whether in parts and particular
organs, or in the whole. — In Synocha, or General In-
flammatoiy Fever, so far as such can exist independent
of visceral or other local disease : — in Febrile Inflamma-
tion, as Erysipelas, Variolte, Morbilli, and Scarlatina An-
ginosa : — in Rheumatism, and Rheumatic Fever, or uni-
versal affection of the joints ; — in Phrenitis, Delirium,
Mania, Apoplexy, Avhether venous or arterial, and in
Dropsy of the Brain : — in Haemorrhages, not excepting
Uterine Hasmori'hages, and especially in Abortions : — in
Peripneumony, or Inflammation of the Lungs ; and in
all cases of Peritoneal Inflammation, this class of me-
dicines is useful.

Bleeding is in ti'uth the most powerful of all sedatives,
that by which we can most instantaneously check and
command the motions of the system, and allay them to
the degree of occasioning instant fainting, and permanent
weakness. — By bleeding, we can also prepare for the acces-
sion of any threatening and acute disease of the brain, the
lungs, the bowels, kc. : it is by repeated bleeding, that we
can best save the internal organs and vital functions ; and
it is according to such danger, that blood is to be permit-
ted to flow in greater quantity, and in a fuller stream.

In Synocha, Rheumatalgia, Cynanche, Erysipelate,
kc. mittantur sanguinis uncias duodecim, et repetatur
vespere, si opus sit.

In Phrenitide, Delirio, Apoplexia, Mania, mittantur
sanguinis unciae octodecim, pleno rivo, et si vehemens
sit delirium, usque ad animi deliquium.

Admoveantur temporibus, hirudines duodecim, vel
cucurbitulae cruentae ; et mittantur sanguinis unciae qua-
tuor.

In Pleuritide, Peripneumonia, Catarrho, Hasmoptysi,
mittatur sanguis e vena brachii, pleno rivo, donee faci-
lius halitum trahit aeger, dum fortiter micant arteria?,
vel dum sputum cruentum fluit.

OP COOL AIR, AND COLD ABLUTIONS.

241

Cold is, next to bleeding, the most powerful general
means of lowering and restraining the action of the sys-
tem, and in modern times has been used with great
confidence, but sometimes with very little discrimination.
In Synocha, Cynanche, Morbilh, Scarlatina, Erysipelas,
all the innovation we have ventured upon in modern
times, is to take off that absurd load of bed-clotlies by
which the physicians of the old school, and tlie vulgar
of all countries, sought to expel the morbific matter of
those diseases, and to admit a stream of fresh cool air to
circulate round the sick-bed.

In Plirenitis, Delirium, Apoplexy, Mania, and similar
diseases, a more active process is required. The patient
is exposed in many of those diseases, according to the
discretion of the physician, to extreme cold : The

patient is kept naked night and day in mania and fury,
while pails of cold water are sluiced over him, sometimes
with the happiest effect.

In Phrenitis, Peripneumony, Haemoptysis, aftd other
Haemorrhages, cool air only is allowed, but seldom the
active application of cold.

In Fever, especially in Synochus, Typhus, Scarlatina,
&c. cold is more actively employed : — the best method, ac-
cording to my opinion and experience, and one which
is at once moderate and availing, is laving continually
cool vinegar and water, or iced water, upon the face,
neck, and bosom, the hands and the arms ; paddling
with the hands in the cool vinegar and water, or
applying it with sponges : — But many prefer (and there
are cases which require it) sponging the body all over,
or taking the patient up from his bed, and sluicing
him with pailfuls of cold water. This process, es-
pecially in warm climates, has saved innumerable
lives. Cold water is showered from* a watering pot, or

VOL. TIT. - Q

4

242

SEDATIVE POWER OP EMETICS.

.splashed upon tlie hands, face, neck, and whole body,
with sponges, or sluiced over the patient by pailfuls ;
the effect produced by such cold ablutions, is at once
pleasing and salutary. But they must be resorted to with
these precautions, viz. never in extremely feeble or delicate
constitutions ; never too long at a time, go as to depress
irrecoverably the vital powers ; never unless tlie tem-
perature be above the natural standard ; never unless it
is steadily above the natural standard ; never during the
cold stage, nor in the beginning of fever; never in
the last stage of t}ie plague, yellow fever, or other low
and mortal typhus.

Cold is equally useful in many less important cases.

In all cases of local inflammation, or excited vascular ac-
tion, it is as useful as in fever ; Therefore, all our sa-
line or metallic astringents, our solutions of Acetate of
Lead, Acetate of Ammonia, Murias Sodje, &c. are ap-
plied cold, and renewed continually, as are also Collyria ;
injections in Gonorrhoea; cooling embrocations in Phleg-
mon, Carbuncle, and Erysipelas, in Ulcers, in Tinea
■Capitis, in cutaneous eruptions and diseases. — In parti-
cular inflammations affecting the structure of massive :
parts, as in a limb universally bruised, in a diseased tes-
ticle, or other gland, we produce artificial cold by em- -j
brocating with spirits. Camphorated Spirits, (Ether, ke. I

Next to these in power, stands the depressing influ-
ence of Emetics, given in nauseating doses, whence their
almost specific power of arresting fever, or, in other
terms, subduing vascular action. Emetics are in this
allied to narcotics. Emetics fii’st sicken the system, f
by their operation on the nerves of the stomach, and
presently all the animal and vital functions are sub-
dued. Narcotics often stimulate in the fii’st operation, but
when they affect the system, so as to subdue the vital
motions, they sicken at the same time that they subdiro.

PRESCRIPTIONS OF ANTIMONY AND IPECACUAN. 243

This is the operation of antimony in fevers, the effect
of which, in causing vomiting, is the least important of
its purposes.

An emetic, especially of antimony, followed by an
opiate, is a succession of sedative powers, almost irre-
sistible. It stops arterial action, appeases irritation, as-
suages pain, and procures sleep and perspiration. It is
the safest prescription in the early stage of every fever,
and often arrests it.

1. R. Pulveris antimonialis grana octo,

Sacchari puri grana quindecim.

Fiat pul vis emeticus statim sumendus.

2. B:. Tartritis antimonii grana tria.

Solve in aquse distillatae unciis quatuor.

Fiat solutio, cujus sumat asger quartam partem omii;i
quadrante hora, donee excitatur vomitus.

3. R. Vini ipecacuanhae, unciam pro emetico ; vel, .

4. Capiat aeger Ipecacuanhaj scrupulum pro Eme-

tico ; vel,

.5. R. Pulveris ipecacuanhas grana decern,

Tartratis Antimonii granum.

Aquae menthae piperitae,

Syrupi simplicis aa unciam cum semiss.

Fiat haustus emeticus, vespere sumendus, et vomitu ces-
sante, sumat aeger haustum tepidum vini rubri diluti :
hora somni, habeat tincturae opii guttas triginta, vel
haustum anodynum.

Lauri Cinnamoni unciam,

Syrupi semiunciam, ,

Tincturae opii semidrachmum. -
Fiat haustus anodynus, hora somni sumendus.

, Q 2

244

antimony and opium.

7. Capiat pulveris Ipecacuanhae, scrupulum vespere (i

et hora somni haustum anodynum, cum cyatho
seri vinosi.

8. R. Pulveris ipecacuanhas grana quindecim,

Tartratis antimonii granum.

Fiat pulvis emeticus statim sumendus, superbibantur ,
aquas tepidae cyatlii aliquot, et vomitu cessante, ha- j
beat haustum vini rubri et aquas tepidas.

To support an unceasing nausea and dejection, is still
more profitable, and is especially beneficial in the first :
stage of inflammatory diseases, as Scarlatina, Cynanche
Tonsillaris, Rheumatism, Measles, &c. For this pur- |
pose antimony is given from hour to hour, sometimes in
powder, sometimes in solution, and occasionally com-
bined with all varieties of sedatives and narcotics, as
with Nitre, with Camphor, with Opium, with Hyoscy- *
amus, with Aconite, Digitalis, Calomel, &c. '

Pulvis Jacobi, James’s Powder, the Oxide of Anti-
mony, is often given as a sedative in colds, fevers, and
rheumatisms, and continued in small doses from hour to ;
hour, till it causes vomiting, purging, or perspiration,

or excites, as it often does, all these secretions at once.

/ <

9- R. Pulveris antimonialis grana sedecim, '

Pulveris Lauri Cinnamoni, |

Sacchari puri. aa 0i.

Tere simul, et divide in doses quatuor : sumat ajgcr
imam tcrtia quaque hora.

10. R. Tartratis antimonii, gr. ii.

Sacchari, 9i. m. et divide in paites equales
quatuor, quarum capiat seger unam omni
bihorio.

antimony with neutral salts.

245

I 11. R. Vini tartratis antimonii,

I Tinctura opii aa 5ii*

Aquae lauri cinnamoni ^viss.

Syrupi simplicis ^iss.

Fiat mistura diaphoretico anodyna, cujus sumat aeger
unciam unam, secunda quaque hora.

Antimony is best combined in fever, or in inflamma-
tory diseases, with saline sedatives, with saline draught,
and laudanum.

12. R. Carbonatis potass,

Acidi citrici q. s. ad saturationem.

Aquae lauri cinnamoni ^vi
Syrupi curi aurantii
Tartratis antimonii gr. ii.

I Fiat mistura : capiat aeger cochlearia duo magna, secunda
I quaque hora.

Or with nitre.

I 13. Be. Mtratis potassae ^ii-

Aquae lauri cinnamoni,

, r fontis, aa ^iii.

Syrupi dianthi caryophylli ^i.

Tartratis antimonii gr. ii.

j Fiat mistura, cochlearia magna duo, quaque hora se-
j cunda.

I Or with acetas ammoniae.
i 14. Be. Aquae acetitis ammoniae ^iii.

Aquae lauri cinnamoni,

fontis, aa |iv.

i Vini tartratis antimonii

i Fiat mistura, sumat aeger cochlearia duo, quater in die.

246 antimony with camphor and opium.

Or as in typhus, with camphor or with opium. .

15. Be. Camphorae 3ss.

CEtheris sulphurici cum alcoholo 5iii-
Aquae lauri cinnamoni ^iv.

* fontis ^iii.

Syrupi dianthi caryophylli 3i.

Vini tartratis antimonii 5iii.

Fiat mistura, cujus sumat aeger unciam quater in die.

16. Be. Pulveris antimonialis grana tria.

Camphorae grana quatuor.

Conservae rosae gallicae grana sex.

Fiat bolus, ter in die repetendus.

This form of antimony is always a sedative, but with
a change of properties proportioned to the dose. From
three to six grains of James’s Powder prove diaphoretic ;
ten grains prove purgative, and beyond ten gvains it
proves emetic, still lowering the pulse, sickening the
patient more and more, and producing diaphoresis.

17. Br. Pulveris Jacobi vel antimonialis gi*ana quin-

que.

Opii granum.

Conservae rosa^ q. s. ut fiat bolus, ter quaterve in di^
sumendus.

18. B. Tartratis antimonii gr. ii.

Aquae rosae centifoliae.

fontis, aa 3iii.

Syrupi caryophyllae Jss.

Tincturae opii camphoratae 5h-
Fiat mistura : Sumat aeger unciam secun^a vel tertia
qu^que hora.

antimony with digitalis.

247

19. R, Aquae camphoratse 5!.

Vini antimonialis
' Tinctiuae opii 5ss»

Aquae lauri cinnamoni ^ss. '

Haustus diaphoreticus, hora somni sumendus.

Or the same sedative and diaphoretic medicines may
be given at going to bed in form of pill.

20. R. Oxidi antimonii grana octo.

Opii granum.

Confectionis rosae gallicae grana quinque.
Fiat bolus, hora somni sumendus, ex cyatho seri lactiS
vinosi.

21. R. Pulveris oxidi antimonialis vulgo Pulveris

Jacobi grana quatuor.

Pulveris ipecacuanhae compositus grana de-
cern.

Fiat pulvis opiatus hora somni ex syrupo deglutiendus.

In extreme pain of rheumatism, and especially of
rheumatic fever, when every stroke of the arterial sys-
tem tlurobs through every joint, and the heat of the bed
aggravates the pains to a distracting degree, the an-
timony has happy effects if combined with digitalis.

22. R. Pulveris digitalis purpureae.

. Opii, aa granum.

Oxidi antimonii gr. iv.

Sacchari pm*i.

Pulveris cort. lauri cinnamoni, aa gr. x.

Fiat pulvis, quater in die sumendus.

il48 ANTIMONY WITH ACONITE OR CALOMEL.

Or it is combined with a still more dangerous and power-
ful narcotic, the Aconite.

23. Be. Aconiti napeUi folionmi exsiccatorum.

Antimonii sulphureti, aa granum.

Carbonatis magnesiae grana decern.

]\I. lit fiat pulvis, omni bihorio sumendus.

It is a fact which forces itself upon our observation,
and is indeed well worthy of notice, that the most
powerful and irresistible sedatives of the vegetable tribe,
are those which, while they lower the pulse, at once
sicken and purge. There is nothing, then, more natu-
ral, than so to combine medicines, as to imitate this na-
tural operation. The combination of antimony and ca-
lomel is especially effectual ; either in more active doses
it is useful in fever ; or in more minute doses, and given
daily, for a long space of time, it is an effectual altera-
tive m eruptive diseases, i. e. a sedative, which abates
the circulation universally, and that of the skin more
especially.

24. Be. Oxidi antimonii gr. iv.

Submuriatis hydrargyri gr. vi.

Sacchari puri gr. x.

Fiat pulvis purgans, mane sumendus, et meridie vel
vespere repetendus.

IS^ext to the depressing power of emetics, is that of
purging medicines ; and it is one of the prime virtues
of antimony, not merely to sicken the stomach, but to
affect the whole course of the alimentary canal, and so
j)oison or depress the s)"stem, empty the stomach and
bowels, and procure a new and increased secretion from
then surfaces ; whence it proves very effectual in lower-
ing the pidse in febrile and inflammatory diseases, and es*

OF SAI.INE PURGES.

249

pecially in exanthematic diseases : and one point of-
management is often of no slight importance, viz. to
give small doses at distant intervals, so as to sicken a
little, and purge a great deal, and leave the patient,
after all, perspiring.

1

25. R. Tartritis antimonii gr. ii.

Solve in aquas distiUatas ^viii.

Fiat solutio, cujus sumat aeger cochlearia duo ampla
quaque semihora, donee vel vomitus, vel alvi dejectio,
leniter excitentur.

In the process of allaying incited vascular action,
whether inflammatory or febrile, saline purges stand
next in order to sickening medicines.

26. R. Phosphatis sodae, ^i.

^Ivendum in jusculi Bovini libra, and mane sumendse,

27. R. Tartritis potass® et sod® unciam, solve in

Aqu® fontis

cinnamomi ^ii.

' Syrupi simpl.

Sit solutio tribus vicibus sumenda.

28. R. Sulphatis sod®, drachmas sex.

Sacchari purificati,

Supertartritis potass®, utriusque drachmas
duas.

Aqu® fervid®, uncias duodecim.

Fiat solutio purgans, partitis vicibus sumenda.

29. R. Sulphatis sod® unciauL

Aqu® uncias octo.

Sympi unciam.

250

KEUTRAL SALTS AS SEDATirES. *

Fiat solutio cathartica tribus vicibus sutnenda, donee
copiose dejiciatiir alvus. / ,

The cooling Neutral Salts are next in order as seda-
tives : They are given in febrile and inflammatory dis-
orders, from hour to hour, throughout the whole day,
and night too, while the patient is not asleep : ^they
loAver the pulse, cool the skin, clear the head, gently
loosen the bowels, and produce perspiration, or tendency
to perspiration ; and they are, in fever, the medium, by
which we convey frequent doses of camphor, of sulphu-
ric cether, of nitric oether, of tartrate of antimony, and
other sedative or sudorific medicines, according to the
exigencies of the case.

Saline effervescent draughts have all those effects^
besides composing the stomach, and preventing retching,
by evolving carbonic acid gas.

/

30. Be. Subcarbonatis potassae scrupulum.

Aquse lauri cinnamomi drachmas duas.

distillat£B drachmas octo.

Sympi citri aurantii 3ii*

Fiat haustus, cum cochleare magno acidi citri medicae,
in statu effervescentiae sumendus, et quarta quaque
hora repetendus.

Or with ammonia instead of potass.

31. Be. Subcarbonatis potassag

Solve in aquae fontis ^i.

32. Be. Acidi citrici 3SS,

Sympi, aquae, aa Jii.

Solutione carbonatis potassae prius sumpta, haustus e

saline LIlAtGHT WITH ANTIMONY. 251

succo ditri, illico' porrigendus est; iit in ventriculo
- evolvatur ^cidum carbonicum.

33. R. AmmoniaB drachmum,

Acidi citrici cochlearia tria magna ^iss. vel
5iss. vel q. s. ad saturationem Ammoni® ;
■^1^ Aqu® lauri cinnamomi.

fontis aa uncias duas.

• ^Syrupi simplicis Jss.

Fiat mistura salina, cujus cochlearia tria, vel unciam
imam cum dimidio, quaque bora sumenda.

Or with the addition of tartrate of antimony.

34. ' R. Subcarbonatis potass®

Acidi citrici recentis |iss.
vel q. s.

Aqu® ros® centifoli® ^ii.

fontis 5iv.

Syrupi citri aurantii 5SS.

Tartritis antimonii gr. ii.

Fiat mistura, cujus capiat ®ger cochlearia tria, secunda
quaque hora.

35. R. Nitratis potass® 3iss. '

Oxymellis (viz. mellis et aceti) 3i*

Aqu® 3viii. misce.

Dentur cochlearia tria ampla, tertia vel quarta quaque
hora.

Nitre Draught.

36. R. Nitratis potass® 3iss. solve in
Aqu® camphorat® ^iv.

lauri cinnamomi 5U.

Syrupi citris aurantii di-
spirit. oether. nitrici Jiii.

252

NITRE DRAUGHTS AND EMULSIONS,

Fiat mistura, cujus sumat aeger cochlearia tria magna,
saepius in die,

37. R. Emulsionis Arabicae Ibii.

Nitratis potassas 3ii*

Capiat aeger pro potu communi.

I

38. R. Nitratis potassae 3iss.

Solve in serf lactis Ibii. pro potu communi, in Febribus,
Hydrope, Gonorrhoea, Nephritide, &c.

39. R. Nitratis potassae drabhmam.

Solve in aquae rosa? centifoliae hbra.

Syrupi simplicis uncia una.

Tincturae opii 3i-

Fiat mistura, cujus sumat aeger cochlearia tria quaque
hora.

Or the saline and nitric draughts are often conjoined.

40. R. Carbonatis potassae 3ss.

Acidi citrici, q. s. ad saturationem.

Nitratis potassae 9i.

Aquae fontis Jiss.

Syrupi simplicis 3iii.

Fiat haustus tertia quaque hora sumendus.

Or with a slight tincture of an emetic.

41. R. Subcarbonatis potassae 9i.

Succi citri medici, q. s. ad saturationem po-
tassae.

Nitratis potassae gr. viii.

Aquae cinnamomi.

fontis aa ^i.

Syrupi simpl. 3iii-
Pulveris i^ecacuanhae gr. ii.

. SALINE AND NITRIC DRAUGHTS.

Misce ut fiat haustus, ter in die sumendus.

Or with Spiritus Mindereri, either instead of nitre, of
along with it.

42. Be. Nityatis potass®

Aqu® acetitis ammoni®. •

lauri cinnamomi*

^ pur® aa ^i-

Syrupi simplicis ^ss.

Fiat mistura, cujus sumat ®ger cochlearia tria magna,
quater in die.

43. Be. Nitratis potass® drachmam.

Aqu® lauri cinnamomi uncias tres.

Solve, et adde,

Aceti sescuntiam.

Sumat seger unciam tertia vel quarta quavis hora.

44. Be. Aqu® acetatis ammoni® ^ss.

Aqu® distillat® 5x.

Syrupi citri aurantii 5n*

Nitratis potass® gr. viii.

Vini tartratis antim. (Pharm. Edin.) ^ss.

Fiat haustus, omni quadrihorio sumendus.

Or with laudanum, antimony, or camphor.

45. Be. Aqu® acetatis ammoni® 5hi-

lauri cinnamomi ^i.

Syrupi amomi zingiberi 3ii*

Tinctur® opii gr. xxxv.

Misce ut fiat haustus, hora somni sumendus.

46. Be. Corticis lauri cinnamomi pulveris gr. vr.

Sacchari purificati gr. xv.

Nitratis potass® gr. viii.

Fiat pulvis, quater in d^e repetendus.

234 POWDERS or antimony, ipecacuan, and nitre.

47. R. Pulveris ipecacuanhac gr. viii.

antimonialis

Nitratis potassae

Sacchari purificati aa 3ii- *

jNIisceantur terencjp, ut fiat pulvis, in partes 6 dividen-
das ; siimat acger partem imam ter in die.

48. R. Camphoraa 5ss.

Nitratis potassae ji- *=•

Sacchari 3ii-

Tere camphoram cum alcoliolis paxillo, dein misce ut
fiat pulvis, in partes sex aequales dividendus ; sumat
aeger partem imam ter in die, superbibendo Cyathum
Eniulsionis Amygdali.

Perhaps there is reason to say, that in the more in-
tense inflammatory diseases, especially in Hydrocepha-
lus, in Peripneumony, in Peritonitis, in acute Rheu-
matism, and in Haemorrhages, the sedative power of
Digitalis is less valued than it should be, and not used
according to its rank and efficacy. In combination with
saline sedatives, with Camphor, or with Nitre, it abates
vascular action, appeases pain, and reduces the swelling
of the joints in Rheumatism, and in the Inflamed Gout
of young and vigorous subjects. In a few hours the"^
experiment is effectually and safely made, whether it
will or will not abate the suffering ! If it compose the
spirits, which opium will not do, and procure ease and
sleep, and slacken the throbbing of the pulse, all is
well.

I

DRAUGHTS OF NITRE AND DIGITAEI§. 25<^

49. R. Nitratis potass£e 9ii.

Tincturae Digitalis 3ii.

Aquae cinnamoni Jiii.

rosas 5ii.

Syrupi simplicis ^i.

Fiat mistura, cujus cochlearia duo adhibenda sunt, ter
in die.

50. R. Pulveris ipecacuanhae gr. vi.

IMucilaginis gum arab. vel tragacanthae 5*^’
Misturae camphoratae 3xii.

Syrupi 3ii.

Tincturae digitalis gtt. xv.

Fiat haustus sextis horio sumendus.

51. R. Aquae acetatis ammoniac.

Cinnamoni, aa

Tincturae digitalis gtt. xx,.

Syrupi simpUcis 3ii-

Misce ut fiat haustus, quarta quaque bora sumendus.

The medicine which we should, in case of dropsy,
prescribe as a diuretic, has often, in haemorrhage from
the lungs, or in violent inflammatory disease, the hap-
piest effects as a sedative.

53. R. Nitratis potassae grana sex.

Supertartratis potassae.

Sacchari purificati, aa grana decern r
Pulveris digitahs purp. granum.

Fiat pulvis, bis terve in die repetendus.

And the same happy effects sometimes result from
combining Henbane with antimony and nitre ; for hen-
bane and fox-glove are often precious anodynes in cases
where opiates could not be endured. .

\

'256

OP COOLING DRINKS.

53. R. Pulveris foliomm Hyoscyami iiigri grana
octo.

Pulveris Jacobi semidrachmam.
Supertartritis potassee.

Sacchari purissimi, aa drachmam.

. Tere simul optime, et divide pulverem in chartulas de-
cern, habeat unam bis vel ter in die.

The cooling draughts, or diaphoretic draughts as they
are termed, or powders of Nitre, Camphor, Acetate of
Ammonia, &c. Hitherto prescribed, are useful in fever ;
those latter prescriptions are more proper in acute
inflammatory diseases, and in dangerous haemorrhages.
But in all diseases of intense arterial action, whether
simple fever or visceral inflammation, sedative draughts
and COOLING drinks are required ; draughts and drinks
acidulated with Nitric Acid, Vinegar, Supertartrite of
Potass, Nitre, &c. are required.

54. R. Lactis vaccini recentis.

Aquae fontanse utriusque libram.

Mistis et ebullientibus adde.

Aceti unciam.

Aufer coagulum, dos, libra.

55. R. Lactis vaccini recentis libram.

Supersulphatis alumina; et potassae drachmam.
Coque paulisper, et aufer coagulum, dos, unciae duae, bis

terve in die.

56. R. Acidi Nitrici 5i-

Syrupi ^i.

Aquae distiUatae ^xii,

Habeat pro potu ordinario.

antiphlogistic drinks.

S57

57. R. Emulsionis amygdali.

Nitratis potassae 51. '

Sumat cyathum modicum omni trihorio.

58. R. Nitratis potassae solve in

DecoCti hordei Ibii.

Ut fiat potus ; vel,

59. R. Nitratis potassae

Aceti.

Sympi, aa ^ii.

Aquas distillatae ^xii.

Potio quotidie bibenda.

60. R. Acidi sulphuric! diluti 51 *

Sympi rosae ^ii.

Aquae distiUatae ^xiv.

Misce pro potu quotidiano.

61. R. Acidi oximuriatici 5ss.

Sympi Aurantii ^ii.

Aquas distiUatae 5xiii.

Fiat potio quotidie sumenda, partitis vicibus.

62. R. Decocti hordei Ibii.

Acidi sulphuric! diluti drachmam.
Mellis despumati semiunciam.

Fiat potio.

63. R. Super-tartritis potassae ^ss.

MeUis despumati ^ii. solve ii^.
Aquae fervidae Ibii ; adde,

Vini Maderiensis cyathum. -
u

VOL. Ills

258

*

COOLING CLYSTER*

But in low and lingering fever. Nitric or Su^hu-
ric (Ether is added to the cooling drink.

64. B:. Supertartritis potassee 5ii*

Aquas fontis Ibii. ^

Syrupi simplicis ^ii* ^

(Etheri sulphuric! cum alcoholo 3ii*

Misce pro potu.

One aid more in lowering the tone of the vascular'
system must be suggested, viz. a Glyster, corresponding
in design and effect with these saline and acid drinks,
and mixtures. ^

65. R. Pulp, tamai’iiidiorum 5SS. ;

Supertartritis potassae 5ii*

Aquae bulientis Jv. : colatur, adde
Aquae cinnamoni
Tartratis antimonii gr. i.

Sumat cochlearia quatuor, et repetatiu* dos post horas i
duas, nisi alvus prius respondeat.

66. R. Decocti hordei vel avenae selibram.

Aceti unci as tres.

INIisce ut fiat enema aceticum.

This glyster is often used iij sudden Aj^oplexy, in Deli-
rium, and inPhrenitis Hydrocephalica; and it is especially
useful in those cases, where a person is found lying in- j
sensible from excess in the use of ardent spirits ; from
having unfortunately mistaken laudanum for any other
medicine; or from being poisoned by any narcotic
drug.

OF SEDATIVE AND COOLING SOLUTIONS. 259

I *

After these saline juleps, and acid drinks, are to be
enumerated, the many domestic mixtures of similar ef-
ficacy, among which are principally to be mentioned,
a dn'nk of Nitre, Vinegar, Honey, and Water. — Impe-
rial, viz. a' solution of cream of tartar, and sugar, in
water : — Vinegar, water, and sugar : — Vinegar whey,
lemonade, apple tea, cyder, black-currant-jelly in water,
cooling fruits, especially grapes, gooseberries, strawber-
ries, apples, pomegranates, melons ; and in hot countries
tlie water melon, or pumkin : Ices and iced waters.

External Sedatives.

It is in fevers and inflammations that the medicines
just enumerated are used. They are powerfully assist-
ed, when the disease or its cause is local, by the appli-
cation externally of slightly astringent and cooling solu-
tions. When the disorder is in the brain, such solutions <
are poured over the head ; when in the testicle, the part
is splashed with it : In an inflamed inguinal gland ; or
in ulceration of the throat, or inflammation of the eyes,
running from the urethra, or in women from the va-
gina, the same astringents are applied in form of colly-
ria, gargles, or injections. Still, such applications are
useful merely by moderating the incited vascular ac-
tion ; and amongst them all, none is preferable to vine-
gar, none more easily procured.

In all affections of the brain ; in all general bruises of
the limbs, with extravasation of blood ; in sprains, in
inflammations of the glands or skin, in fonn of buboe
or phlegmon ; in swellings of the testicle, and all simi-
lar diseases, cold vinegar and water are to be incessantly
poured over the part affected ; and a poultice, or cold
mess of bread, linseed, oat-meal, &c. with vinegar, is to
be applied, and moistened anew from time to time.

26’0

COOLING SOLUTIONS.

67. li. Farinae vel seminis lini, vel

Micarum panis quantum vis.

Aceti quantum satis,

Ut fiat CATAPLASMA acetatum, frigidum applicandum,
et quando siccum, vel calidum factum fuisset, reno-
vandum.

68. R. Acetatis plumbi 9i.

Acidi acetati diluti 5i-
Aquae ^v.

Fiat solutio resolvens, linteum hocce liquore frigido ma-
defactum, applicetur partibus afFectis, et saepius reno-
vetur in contusionibus, contortionibus ai^ticulorum, in-
flammatione cutis, mammamm, oculorum, urethrae,
vaginae, vesicae urinariae, in adustis, et in ulceribus.

'69. R. Micae panis, quantum vis.

Solutionibus acetatis plumbi supra,
Frescripti quantum satis,

Ut in cataplasma madescant

Nitre, which produces so singular a sense of coolness
on the tongue, is often used as a sedative gargle for Cy-
nanche tonsillaris, and Apthae.

70. R. Nitratis potassae 5ii*

Aquae rosae.

fontis, aa 3iv.

Syrupi simpl. ^iss.

Aceti 5ii-

Misce pro gargarismate.

Oi* Borax, which resembles nitre in taste, and in the
cold impression it leaves on the tongue, is used in its
stead.

OF COOLING APPLICATIONS.

261

71. R. Sub-boratis sodse 9ii.

, Aquas rosse

Syrupi aceti ^iss.

Misce pro gargarismate.

72. R. Sub-boratis sod« 5^^^-

Aquae ferventis ^v.

Mellis rosae
Misce pro gargarismate.

The malic acid, strengthened by a small proportion
of vinegar, or of sulphuric acid, is found to be an excel-
lent cooling application in inflammatory and acute 5p-
thalmia.

73. R. Pomorum dulcium quantum vis.

Coque ex aqua, et exprime per linteum ; dein adde, ad
unciam pulpae, guttas viginti acidi sulphurici, vel
acidi acetici puri drachmam, pro cataplasmate op-
thalmico.

Or with camphor.

74. R. Pulp£B pomorum Jii.

Camphorae gr. x.

Acidi acetici impuri 5iii»

Misce, ut fiat cataplasma opthalmicum.

(Ether, Alcohol, and Vinegar, Camphorated Spirits,
&c. are very precious applications in bruises, sprains,
and inflammatory diseases, in which they operate as se-
datives, producing a, degree of coolness much greater
than that of the coldest solution, or even of ice. Their
stimulant effect is procured by gentle friction, or by per-
manent application ; their cooling effects, by simply
pouring them over the inflamed part, and suffering them

S63‘

OF COOLING APPLICATIONS.

to evaporMe, and helping them to do so, by breathing
and blowing upon the part. In intense headaches, ce-
phalalgia, tnd ce^alea ; in nervous affections from the
pressure of tumors ; in swelling of the testicle or ingui-
nal glands ; in rheumatism, &c. the cold produced by
the evaporation of oether, or the slower effect of caim
phorated spirits, is of great avail.

76. B:. (Etheris sulphuric! 5b.

Admoyeatur front!, vel temporibus, vel aliae parti, do-
lenti, linteum madidum oethere : calore, evaporation*
oetheris, subducto, levatur dolor,

77. B:. (Etheris sulphuric! alcoholizati ^ss.

Aceti 5ii.

Aquae camphoratae 3xii.

Fiat lotio. * '

«

These are to be applied to the shaven scalp in Hydro-
cephalus, Phrenitis, Dehrium Ferox, and in Apoplexy ;
or the head may be sponged with cold vinegar and water.

78. B. Camphorae ^i.

Aceti Jii.

Aqu£E distrUatae Ibiss.

Fiat lotio frigida.

Class II.

OF NAKCOTICS AND ANTISPASMODICS.

First in rank for allaying arterial action, and saving
the lungs, the brain, the abdominal viscera, from in-

OP NARCOTICS.

S63

* •

flammation in active haemorrhages, especially haemoiv
rhages from the lungs, and for relieving the joints, in
rheumatic disorders, stands Digitalii, Qf gll prepara-
tions, the Infusio Digitalis is the safest.

79. R. Fol. digitalis purpureae ^ii*

Aquas bulientis Ibiss.

Post horas duas cola, et adde,

Spiritus cetheris nitrosi ^i.

^isce, capiat cochlearia larga duo quarta quaque hora.

Or tincture, or spirituous infusion.

80. R. Pulyeris fol. digitalis purpureas ^i. .

Alcoholis, '

Aquae fontis aa Jii.

Infunde, et post horas viginti quatuor cola : sumat asger
guttas viginti bis terve die.

81. R. Infus. rosae Gallicse ^iss.

Tincturae digitalis gtt. xviii.

opii gtt. XV. . .

Fiat haustus, sexta quaque hora sumendus.

82. R. Tincturse digitalis gtt. xxv.

Acidi sulphurici diluti gtt. xv,

Aqu£e cinnamomi 5xii.

Syrupi amomi zingiberi 5ii-
Fiat haustus, sexta quaque hora sumendus.

Such draughts are to be used in Haemoptysis, viz.
with Sulphuric Acid and Opium,

264

DEAUGHTS AND POWDEES Ol" DIGITALIS.

83. Be. Infus. rosae Gallicee 5isS.

Acidi sulphurici diluti.

Tincturae opii aa gtt. xv.

Syrupi dianthi caiyophyli 5ii*

Fiat haustus, quater in die adhibendus.

84. Be. Camphorae gr, iv.

Pulveris fol. digitalis gr. i.

Sacchari purificati

Tpre simul addendo alcoholis pauxillum, et dein adde
Aquae lauri cinnamomi ^i- ut fiat haustus, ter in die
sumendus.

85. Be. Pulveris fol. digitalis purpureas gr. i.

Jacobi gr. v.

Conserv. rosae q. s.

Ut fiat bolus,' quarta vel sexta quaque hora sumendus.

Such a bolus, or corresponding draught, is of especial
service in acute Rheumatism.

86. Be. Nitratis potassae gr. vi.

Pulveris digitahs purpureae gr, i.
Supertartratis potassae.

Sacchari puriss. aa gr. x.

Tere simul ut fiat pulvis, quarta quaque hora sumendus.

87. Be. Pulveris digitalis purpureae gr. v.

Extracti hyoscyami nigri Qi.

Pulveris antimonialis gr. xii.

Mucilaginis q. s.

Ut fiat massa, formanda in pilulas sex. Sumat aeger pi-
lulam quarta quavis hora.

IVhen Digitahs is prescribed in the phreuitic stage of

greateh doses for mania, &tc.

265

Hydrocephalus, it is usually in a boy of five or ax years
of age, to whom it may be given in theYollowing form.

88. R. Nitratis potassae gr. vi.

Tincturae digitalis purpureas gtt. viii.

Aquas distillata)

Syrupi citri aurantii 3ii*

Fiat liaustus, tertia quaque hora adhibendus.

In Mania, or Inflammation of the Brain, in the adult,
Hyoscyamus may be given in much larger doses.

89. R. Camphorse gr. xii.

Alcoholis pauxillum.

Aquae cinnamomi.

fontis aa ^i.

Syrupi citri aurantii 3ii- ~

Tincturas digitalis purpureas 3i-
Fiat haustiis anodynus, mane et vespere adhiben,dus.

90. R. Camphoras gr. xii.

Pulveris digitalis purpureas.

Hyoscyami nigri aa gr. iii.

Sacchari purificati P)i-
Fiat pulvis, bis in die sumendus.

The lesser anodynes of camphor and opium, such as
are usually prescribed, sometimes in doses so gentle, as
to prove merely cordial in low fevers, sometimes in larger
to procure sleep, shall be noticed presently.

We continue to speak now of deep and powerful
anodynes, such as are fit to be given in gradually in-
creasing doses, to those tortured with pain ; or all at
once in the more terrible disorders of Insanity, Phrenzy,
Hydrocephalus, Convulsions, kc. : and such powerful

\ •

$66

CONIUM MACULATUM.

anodynes are most naturally prescribed in form of pills,
for they are the extracts of Opium, of Hyoscyamus, of
Conium Maculatum, &c. Opium is more familiarly
used in Colds, in Fevers, in Inflammations of tlie
Bowels, as an anodyne, or as an astringent ; but in con-
junction with the more powerful narcotics, as Conium,
&:c. it is very useful for still more important purposes.

91. B:. Opii.

Extracti hyoscyami nigri aa gr. iii.

Fiant pilulae duas, sexta quaque hora sumendae.

92. R. Extracti hyoscyami grana decern.

glycirrhiz. ^ii.

Misce lit fiat massa dividenda in pilulas decern; sumatur

una vel altera nod;e maneque, et meridie si opus sit.

Such anodyne pills are frequently given in painful
nervous affections, in cancerous cases, and in ulceration
of the bladder : and while they serve as anodynes, they
do not bring ivith them the stupifying headach which
opium occasions, and may be gradually increased, till
the patient takes with benefit ten grains, i. e. the whole
mass, in the course of the day. But in Mania, half the
mass may be given at a dose, and that not gradually,
but rapidly increased, till the irritation is subdued.
Opium is frequently given in Mania and Hydrophobia,
in repeated doses of one scruple each ! sometimes to^ the
amount of half a drachm, or two scruples, and with the
happiest effects, after emetics.

Hemlock, the favourite medicine of Stork, is given,
as Hyoscyamus is, more frequently in extract, and often
along with Hemlock, not unfrequently in substance.

93. R. Pulveris foliorum siccatorum conii maculati 5^-

CONIUM. — HYOSCYAMUS. — BELLADONA. 267

Fiat massa ope mucilaginis, in pilulas viginti formanda ;
r uiitio sumat aeger unam, (viz. grana tria conii), nocte
•'maneque, postea duas bis in die, ascendens gradatim
ad semidrachmam, viz. pUulas tres ter in die.

94. R. Extracti conii maculati 3ss.

hyoscyami nigri 9i.

Fiat massa, dividenda in pilulas viginti; sumat aeger
initio duas, postea tres, ter in die.

95. R. Extracti hyoscyami nigri.

conii maculati aa gr. iii.

Fiat pilulas sex, quaque hora sumendfe.

96. R. Camphoras.

Extracti hyoscyami nigri aa gr. v.

Pulveris ipecacuanhas gr. i.

Fiat pilulas duse, sexta quaque hora sumenda;.

97. R. Extracti atropas beUadonas gr. ii.

Sacchari purificati gr. vi.

Ji'iat’pulvis, sexta quaque hora sumendus,

98. R. Extracti aconiti napelli gr. i,

Pulveris ipecacuanhae cum opio gr. v.

~ Conservae rosae q. s.

Fiat bolus, quarta, quinta, vel sexta quaque hora^su.,
n;jendus.

99. R. Foliorum napeUi aconiti

Alcoholis diluti ^viii.

Digere per dies septem, et cola dosis guttas tres, ad vi-
ginti vel triginta, in Arthritide, Rheumatismo, &c.

These are used as narcotics, in circumstances where

' 268

USES OF OPIUM.

opium sickens and excites. But still it is to be remem ■
bered, that these, especially Cicuta, are used, not with
the design of repressing excited action, but merely of
suspending the sensibility of the nervous system : They
are used in painful diseases, in Gout, Rheumatism, Tic
Doloreux, Cancer, Disorders of the Urinary Bladder,
Rectum, &c. Opium also is used in the larger doses,
to lull pain, and to operate as an anodyne ; but never
with the design of repressing vascular action, which it
rather excites, and by that procures Diaphoresis. O-
pium draughts of fifty, seventy, or a hundred drops,
or boluses containing two, three, or four grains, are so
useful in subduing pain, that it is the most familiar me-
dicine, and common resource, of those afflicted with
lingering diseases. But that effect of opium which re-
quires artful management, and may be truly called me-
dicinal, viz. which contributes to the cure of disease, is
its STIMULANT property ! As a cordial and diaphoretic
in Fevers, it is used in many various forms ; almost al-
ways in draughts, that its operation may be immediate ;
conjoined with aromatics, that it may prove grateful to
the stomach ; aided by Camphor, or Sulphuric (Ether,
or Spiritus (Etheris Nitrosi, or Antimony, or Calomel.

Camphor, with vinegar, often proves in itself a useful
febrifuge, or a convenient form for combinations with
Opium or Antimony : The Acetum Camphoratum is
designed for such uses.

100. R. Camphorae drachmam.

Alcoholis scrupulum.

Gummi mimosas niloticee pulv.

Sacchari purificati utriusque unciam.

Acidi acetici diluti sesquilibram.

Simiatur unciam s«pe in die, pliiala fortiter agitata.

OPIUM PRESCRIBED AS ANODYNE. 269^

The jnbst simple of all forms of opiate, is the draught,
given merely to compose and abate irritation.

101. R. Pulveris lauri cinnamoni gr. xv.

^ Syrupi citri aurantii 5ii.

Aqu£B rosae centifolise ^xii.

Tinctures opii gtt. xxx. ad 1. vel xc.^

Fiat haustus, liora somni sumendus.

102. R. Pulveris aromaticas

Aquas lauri cinnamoni ^iss.

Tincturas opii gtt. xxxv.

Fiat haustus.

ft

103. R. Tinctures opii.

hyoscyami nigri, aa gtt. xx.

Aquae rosae centifolise 3x.

Syrupi simpl. 3^.

Fiat haustus anodynus, in rheumatismo, podagra, dolore
abdominali, catarrho, inflammatione dolorosa testis,
vesicae, urethrse, glandularum, conglobatarum. Sec.

104. R. Tincturse opii.

digitalis purpur. aa gtt. xx.

Aquse lauri cinnamoni.

fontis, aa 3v.

Syrupi citri aurantii ^u.

Misce, ut fiat haustus anodynus.

From draughts and boluses of the most moderate
power, and suited to relieve the slighter irritation, we
advance gradually through those combinations which
we prescribe in slight hysterical affections, to those
which we venture to give in hydrophobia and tetanus.
Hysterical disorders must be delicately dealt udth, they.

370 OriUM PllESCillBED AS CORDIaA

are connected with irregular menstruation and very ilri-
table constitutions ; the slightest error converts them
into paroxysms of great suffering, and their continuance
draws on lingering indispositions, which ruin the health :
Hysterical habits bear none but very gentle medicinej^
little proportioned to the apparent suffering. \

105. Be. Tincturse opii gtt. xv.

Spiritus oetheris nitrosi 5i-
Aquse lauri cinnamoni ^i- ^

Syrupi 3ii.

JNlisce, ut fiat haustus.

106. R. Moschi.

Pulveris lauri cinnamoni, aa 9ss.

Sacchari purificati 9iss.

Mucilaginis gum. mim. nil. 5ij- tere simul,
dein adde,

Aquas fontis 5iss.

Ut fiat haustus, ter in die sumendus.

Musk is a cordial medicine ; if it be genuine, and have
any effect, it is, like wine, to stimulate and exhilirate.

107. R. Castorei 3i*

Camphoras 5ss.

Tincturae opii 5i-
Mucilaginis gum. mim. nil.

Syrupi citri aurantii, aa ^ss.

Aquas fontis 3V.

Fiat mistura, sumat aeger cochlearia duo magna, secunda
quaque hora, vel ter in die, in moibis nervorum, in
singultu, hysteria, febre petechiali, cynanche maligna.
&c.

OPIUM AS A CORDIAL.

271

108. R. Aquse ammoniae. u

Tincturae opii, aa gtt. x.

Aquae menthae piperitae

Syrupi simplicis ^u.

Fiat haustus, ter quaterve in die sumendus.

109. R. Tincturae valerianae ammoniatae,

Spiritus oetheris nitrici aa 5ii-

Aquae menthae piperitae ^vi.

Fiat mistura, cujus adhibeantur cochlearia tria magna,
altera quaque hora.

110. R. (Etheris sulphurici.

Tincturae opii aa 5ii*

Spiritus lavendulae compositus ^ss. m.
Sumat aeger in cyatho aquae, cochlearium minimum, teP
in die, in ventriculi dolore spasmodico, in arthritide
atonica, vel uti dicitur retrocedente.

It is my opinion, from experience and my own feel-
ings, that opium is infinitely less powerful in proportion
to laudanum, than is usually estimated, viz. a grain to
twenty drops. The effects are not of the same sudden
exhilirating kind. This soothing cordial effect, of
which we avail ourselves so much in low fever and in
nervous diseases, is quite lost, when opium is iven in-
stead of the tincture. But there are circumstances in
which opium may be preferable : And in the more
dangerous diseases, as Hydrophobia, Tetanus, Mania, and
Epilepsy, where wte .venture on very high doses of
opium and camphor, they are perhaps best given in
substance : Even in hysteria and lesser nervous disor-
ders, we prescribe thu.s.

aT2 OF OnVM AS a febiiifugf

'ill. Jx. CampliorfB gr. viii. !

.Mosclii gr. vL
Opii gr. ii.

Fiat pulvis ex syrupo sumendus.

112. R. CainphorcB grana quindeceiii. i

Opii grana duo.

Alcohol, pauxillum.

Confectionis aromaticas scmidrachnlani.

Fiat inassa mollis, in pilulas tres dividenda, ima statim i
sumenda, altera pro re nata. I

113. R. Camphorae grana decern.

Opii grana sex.

Conserve rosse q. s. ut

Fiat bolus, statim deglutiendus in hydrophobia, et se-
cunda quaque hora, vel,

111. R. Submuriatis hydrargjui ^ii.

Opii.

Camphoras aa ^i.

Mucilaginis q. s. ut fiat massa mollis, dividenda in pilu- !
las quatuor, omni semihora deglutiendas, vel saepius
quo sseviores sunt spasmi et horror.

But the cordial and diaphoretic effects of opium, of
which we avail ourselves in slight fever, rheumatism,
exanthemata, sore throat, and especially in typhus, are
produced only by gentle doses and judicious combina- ■
tions ; combining the opium with saline draughts, when
we would have it operate as a sedative or gentle dia-
phoretic,— but with camphor, oether, and serpentaria,
when we woidd support the vital powers. Those medi-
cines, bark excepted, which we should term febrifuges,
are all included in the following series of prescriptions.

FEBRIFUGE CORDIAL DRAUGHTS.

115. R. Carbonatis ammoniae gr. xv. ‘

Acidi citrici q. s.

Aquee lauri cinnamomi ^i.

Syrupi citri aurantii 5“*

Tincturae opii gtt. xxx.

Fiat haustus, quarta vel sexta quaque bora sumendus.

116. R. Misturag camphorate, Phar. Lond. (cujus

libra drachmam camphorse contiiiet), 3viii.
Syrupi lauri aurantii Jss.

Tincturag opii 5i-

Fiat mistura cardiaca, in febre typhoids nocte dieque ad-
hibenda, trium vel quatuqr horarum intervallo ; sit do-
sis cochlearia tria magna, adhibeatut dum delirat aeger.

117. R. Misturse camphoratae 5^-

Syrupi 5ii.

Tincturag opii gtt. xii.

CEtheris sulphurici gtt. xxx.

Fiat haustus, quarta quaque hora adhibendus.

118. R. Aquffi menthae piperitae ^iv.

-'fontis ^ii. * -

Syrupi dianthi caryophilli Ji.

Spiritus o?theris nitrici 5SS.

Tincturse opii gtt. Ixxx.

Fiat mistura, cujus sumat agger cochlearia duo magna
tertia quaque hora.

119. R. Liquoris acetatis ammoniae,

Aquae lauri cinnamomi, aa 5ii.

fontis 3iii.

Sympi citri aurantii ^i.

Q'^tlieris sulphurici 5'ii.

Tincturse opii gtt. lx.

Fiat mistura.

VOL. III.

s

274

OPIATE DRAUGHTS AND EMULSibNS.

120. B:. Carbonatis potassse

IVIistuTEe camphorse 3xii.

Syrupi citri aurantii
Tincturge opii gtt. v.

Fiat liatistus, in bora sumendus, ill statu effervescentia?,
cum cochleari magno acidi citri medici. ^

121. R. Camphoras semidrachmam.

Alcoholis pauxillum.

Amygdalas dulces dicorticatas sex.

Sacchari purissimi drachmas tres. Contere,
et adde,

Aquae mentliae piperitae.

— fontis uncias quatuor.

Tincturae opii giittas quadraginta.

Fiat mistura, cujus sit dosis cochlearia tria magna.

122. R. Camphorae grana quatuor.

Moschi grana sex.

Opii granum.

Syrupi amomi zingiberi q. s.

Ut fiat bolus, ter in die adhibeiiduS. *

123. R. Opii granum.

Pulveris antimonialis grana quatuor.
Conserv. rosae q. s.

Ut fiat bolus, ter in die sumendus, superbibendo Ooch-
learia magna tria sequentis misturae :

124. R. Infiisi rosae gaUieae libram.

Syrupi simpl. ^ii.

Acidi sulplmrici diluti
Vel 5iiss.

AJ^TIMONIAL AND OPIATE DEAUGHTS.

275

125. R. Opii grana duo.

Submuriatis hydiargyri grana sex.

Pulveris Jacobi grana octo.

Conservae rosae q. s.

tit fiat bolus, horn decubitus sumendus, superbibendo
cyathum vini diluti calidi.

126. R. Pulveris antimonialis grana tria.

Carbonatis ammonige grana quatuor.
Pulveris ipecacuanhte cum opio grana sex.
Conservae rosae q. s.

Fiat bolus, quarta quaque bora sumendus, superbibendo
emulsionis camphoratse cochlearia tria.

Emulsio Camphorata, is the emulsion prescribed No.
121. without the laudanum, and with pure Water in-
stead of peppermint-water.

127. R. Pulveris Aristol. serpentariaegr. xii.

Camphorae gr. vi.

, Alcoholis pauxillum.

‘ Mucilag. gum. mim. niloticae.

Syrupi citri aurantii aa 5ii-
Aquae cinnamomi ^i.

Fiat hatlstus, ter in die sumend^us.

Such cordial draughts are particularly usefid in low
fever# with delirium ; but in Sjmocha, simple and gentle
medicines are riiore availing.

128. R. Aquae acetatis ammoniae.

Misturae camphoratae aa 5iii^

Tartratis antimonii gr. i.

Syrupi dianthi caryophylli Ji.
ut fiat mistura, cujus sumantur cochlearia duo ampfe
intervallo semihorae ; vel*

's 2

37(j

ANTISPASaiODICS.

129. R. Carbonatis ammoniee gr. vi.

AqiifE ammoniae acetatis.

Aquas lauri cinnamomi aa ^1.

Syriipi citri medici

Haustus, secunda vel tertia quaque bora adhibendus.

In fever I find it often preferable to make the pleasant-
est of all effervescent cordials, from domestic articles :
Mixing a spoonful of fine sugar, with two spoonfuls of
lemon juice, and a glass of INIadeira ; pouring upon this
an earthen bottle of simple aerated water, (the aqua
acidi carbonici), makes a delicious refreshing draught.

Of Antispasmodics.

There is no class of diseases in which we reason so
little, and practise so empirically, as in those termed
Nervous or Convulsive. — The 'causes which produce
slighter hysterical convulsions, are so trivial, and those
which occasion epilepsy, hydrophobia, tetanus, and other
forniidable convulsions, are so abstruse, that we often
prescribe a round of unavailing medicines. There are
such infinite varieties of spasmodic affections, not only
thus agitating the whole muscular system, but affecting”
particular organs and functions, that in enumerating
the prescriptions, it is necessary to recollect the variety
of uses to which they may be turned, ,

The following medicines are prescribed.

1st, In hysteria we give the milder medicines, a»
Castor, Valerian, &c. and the smaller doses of Opium
and Camphor. 2d, In universal convulsions, as epilepsy,
child-bed convulsions, tetanus, trismus, and hydrophobia,
we give the most powerful doses of mercury, opium,
camphor, &cc. 3d, In gastrodynia, and Cramp of the
Stomach, we give opium, essential oils, and large doses

MUSK. — CAMPHOR.

277

of laudanum, with hot spirits, mulled wine, &c. 4t^, In

Asthma, or Spasm of the Glottis, we prescribe ipecacu-
anha, opium, camphor, and powerful doses of oether.
5tA, In Hooping-Cough, Pertussis, we give ipecacuanha,
oicuta, hyoscyamus, and opium. 6t/i, In Colic, or Spasm
of the Intestinal Canal, we conjoin purges, with warm,
stimulating, antispasmodic medicines. 7t/^, In suppres-
sion of Urine, or Spasm of the Sphincter Vesicae, we
prescribe opium, and opiate glysters ; and from what-
ever cause the strangury proceeds, especially if from the
application of blisters, or the imprudent use of cantha-
rides, v/e give camphor. These remedies I shall not
very studiously arrange according to their order ; it will
be useful to the young Physician to see their several
properties thus recounted ; he must think, select, and
vary them for himself

130. R. Moschi ^ss.

Camphorae gr. vi.

Conservae rosae q. s.

Ut fiat bolus, bis vel ter in die sumendus.

131. R. Castorei 9i.

Carbonatis ammoniae 9ss.

Conservae rosae q. s.

Ut fiat bolus, ter quaque hora sumendus.

132. R. Assafoetidae 5ii-

Aquae ferventis 3viii.

Misc'e, et adde
Tincturae opii ^ss.

Tincturae valerianae sylvestris

Fiat mistura, cujus sumat aeger cochlearia duo magna,
quater in die.

I

278

CETHER, VALERIAN, ASSAFCETIDA.

133. Sumat oetheris sulphurici ; vel^

Aquai ammoniae ; vel,

Tincturas opii camphorataj ; vel,

Alcoliolis ammoniati.

Aromatici 3i- ad 5ii. ex aqua.

134. R. Assafcetida 5ii- *

Camphorae 5i-
Alcoholis pauxilliim.

Aquae fontis ^iv.

IMisce ut fiat enema antihystericum.

Injiciatur vespere, Tincturae opii 5i- i«
aquae tepidas 5iv.

135. R. Tincturae valerianae volatilis ^ss.

lavendul. comp. 5iir

(Etheris sulphurici
Aqua? 5vi.

Fiat mistura, cujus capiantur cochlearia duo saepe in die.

136. R. Alcoholis camphorati 51.

(Etheris sulphmici 3SS.

Fiat embrocatio, quo ilhnatur regionem hypogastrica,

137. R. Moschi.

Sacchari aa 5ii*

ViteUi unius ovis, tere simul, etadde, aquae
tepidse ^iv.

Tincturae hyoscyami nigri ^^ss.

Misce pro enemate.

138. R. Pulveris valerianae sylvestris gss.

Pulveris aromatici
capsici ^i.

et divide in partes aequales sex, quaruni una, quarta

alcohol, murias ammonia, &c.

279

quaque hora sumenda, in suffocatione, cephalasa, he-
mici*ania, clavi hysterica.

189. Be. Aceti ^vi.

Alcoholis di-
spirit. lavenduljE ar. 5SS.

Fiat mistura, cujiis sumat aeger cochlearia magna tria,
bis in hora, vel saepius, in singultu hysterico.

140. Be. Muriatis ammoniae et ferri.

Pulveris amom. zingiberi aa gr. viii.
Miicilaginis q. s.

Ut fiat bolus, bis die sumendus.

When we prescribe for universal convulsions, Hydro-
phobia, Tetanus, &c. we have recourse to camphor,
opium, mercury, and hyoscyamus; and to sickening eme-
tics : and we give these in doses limited by no conside-
ration, but that of subduing the disease, or producing
direct signs of danger.

141. Be. Submuriatis hydi'argyri 5i-

Opii 5ss.

JMucilaginis tragacanthae q. s.

Ut fiat massa, dividenda in pilula sex ; sumat aeger unam
Omni semihora, in trismo, tetano, mania, hydropho-
bia; vel,

142. Be. Extract! hyoscyami 9ii.

Opii 5ss.

Fiat massa formanda in pilulas octo, singulis horis su-
mendas, donee pulsationes arteriarum sufflaminantur,
et reducantur ad quadraginta in minuti spatio ; tunc
stupore affecta, aeger desinat pilulas sumere, atque
etiam viiibus narcoticis oppugnare debeat, haustibus
acidi aceti diluti, vel aquse acidi carbonici.

gSO CAMPHOR Pin, Si.

143. R. Extracti digitalis.

opii.

Tai'tratis antimonii aa gr. ii.

144. R. Extracti digitalis, — opii.

Tartratis antimonii aa gr. ii. ^

Submuriatis hydrargyri gr. vi.

]\Iucilaginis tragacanthae q. s.

Ut fiant pilulae, duae quaqiie bora adhibenda;.

145. R. CamphoraB 5iss.

Eitratis potassas 5i- ^

Extracti gentianae luteas q. s.

Ut fiat massa, dividend, in pilulas duodecim, quarum
sumat phreniticus diias, tertia quaque bora, et bora
somni sumat quatuor ; sed caute et gi'adatim semper
adbibendum est boc remedium : si adveniunt syncope
anxietates, nausea et convulsiones, instanter desinere
oportet, et vice campborae, parvas doses opii exbibere,
cum potu acidi acetici exbibendae.

In Puerperal Conviilsions,' we succeed best by very
profuse bleeding, and powerful doses of camphor and
of opium.

In those desperate conditions of Mania, Hydrophobia,
&c. and in universal convulsions, such as occur in warm
climates, the physician will be directed in his frequent
visits, or by reports brought him from hour to hour,
how far to proceed, what to hope, when to desist.

In the less fatal but ruinous disorder of epilepsy, we
are accustomed to prescribe more trivial medicines in
less efficient doses: one reason perhaps, of our ill success.
The powders of Valerian and Camphor, the pills of
Oxide of Zinc, and Ammoniaret of Copper, should be
supported by copious bleedings and frequent purges., ,

SULPHATES OF COPPER, IRON, ZINC. 281

i

146. R. SubsLilphatis cupri et ammoixiifi grana se-

, deciii).

Succi spissati hyoscyami.

Conii maculati aa semidrachniam.

Micae panis q. s.

Ut fiat massa, in piliilas triginta duas dividenda; su-
mat aeger pilulam bis terve in die, sensim augendo
dosin, si ventriculus ferat

147. R. Sulphatis fern 5*>

Extracti gentianac q. s.

Ut fiat massa, in pilulas viginti dividenda; snmat a'ger
initio pilulam mane, vespere pilulas duas ; postea su-
mat duas mane et vespere, gradatim dosin augens.

Next to the sulphates of iron, are the sulphates and
oxides of zinc.

148. R. Sulphatis zinci gr. iss.

Pulveris radieis glycyrrhizae glabnr.
Cinnamomi aa gr. vi.

Eiat pulvis, ter in die repetendus.

149. R. Sulphatis zinci gr. i.

Opii gr. ss.

Extracti gentianse lutese gr. iii.

Fiat pilula, ter in die sumenda,

150. R. Oxidi zinci 3i-

Sacchari puriss. 5ii-
Pulveris lauri cinnamomi.

— capsici aa gr. vi.

Tere simul, et divide in pulveres duodecim, quanim su-
mat ajger imam tertia quaqiie hora, in epilepsia,
^crophula, asthmate, ^vc..

!

ass >

OXIDES OF ZINC AND ARSENIC.

151. Be. Oxidi zinci gr. vL *

Succi inspissati glycyrrhizaB gr. iv.

Olei menth. piperitae gtt. i.

Fiant pilulse duae, ter in die sumendae.

152. Be. Nucis vomicae contusae ''

Aquae ferventis Ibi.

Macera per horam, dein cola ; hujus infusionis sumantur
pro haustu ter in die, drachmas duodecim, cum tinc-
turse cardamomi drachmis duabus ; vel,

153. B:. Pulveris nucis vomicae.

moschatae aa gi’. ii.

Conservae rosae q. satis.

Ut fiat pilula, ter quotidie deglutienda.

154. Be. Solutionis arsenicae guttas sex.

Aquae lauri cinnamomi Ji.

Syrupi citri am’antii 3ii*

Fiat haustus, ter in die sumendus, ip epilepsia, rheuma-
tismo, febre intermittente.

In Constipation and Colic, arising from inaction or
spasm of the great intestine, opium, and other antispas-
modics, are judiciously combined with small portions of
drastic purges, as calomel, with opium and colocynth.

155. Be. Submuriatis hydrarg}Ti.

Extracti colocynthidis ua gr. viii.

Opii granum.

Olei menth. piperitae gtt. iv.

Fiat massa dividenda in pilulas duas, tertia quaque hora
gumendas. — In such cases opiates are antispasraodics,
and (though in other circumstances they might ope-
rate as narcotics) aid the operation of purges.

ANTISPASMODICS FOR COLIC.

S83

156. Habeat eo tempore pro enemate, tincturae opii 5i. ;
vel, opii grana quatuor ex aquai hordei, vel mucilaginis-
5iv. et illinatur regio umbilici, embrocatione anodyna.

157. R. Vitelli ovi unius.

Olei terebinthinse
Tincturse opii ^ss.

Pro eAibjocatione. '

158. R. Tiiicturas rhaji amarse.

opii gtt. XXXV.

Haustus bora decubitus sumeiidus, resolvens leviore^
gradus spasmi colici, et sine dolore alvum movens.

159. R. Aquae lauri cinnamomi

Syrupi citri aurantii ^i.

Olei menthae pulegii gtt. x.

Spirit, ammoniae fcetidae

Sumat aeger cochlearia duo magna, tertia quaque bora.

160. R. Pulveris baccae capsici indici gr. iii.

Opii gr. ss.

Olei mentbas pulegii gtt. ii.

Fiat pilula, sexta quaque bora sumenda.

161. R. Submuriatis bydrargyri gr. viii. * -

Pulveris lauri cinnamomi.

Saccbari purificati aa gr. ^d.

Olei mentbae piperitis gtt. iv.

Fiat pulvis, statim sumendus.

162. R. Olei ricini Jss. vitelli ovis pauxillum.

Aquae mentbae piperitis
Syrupi citri aurantii 5iii-
Tincturae opii gtt. xx.

Fiat baustus, sexta bora repetciidus

MEDICINES FOR COLIC. *

5^84

163. Be. Pulveris aromatici.

Sacchari purificati aa 5iv.

Tincturae convolvuli jalapi
Aquas menthas piperitas ^iv.

Olei menthse pulegii gtt. x.

Fiat mistura, cujus sumat aeger unciam, (viz. cochlearia
duo magna), quarta quaque hora, vel urgente dolore. ;

I

164. R. Unguenti hydrargyri ^iss.

Opii.

Camphorae aa 5ii. ,

Alcoholis pauxillum.

Olei terebinthinsB 5ii*

Mi see ut fiat embrocatio.

i

Such embrocations, combined with internal medicines, I
I find very useful in cases of imminent danger.

In gastrodynia, not arising from inflammation, but
from indigestion, acidity, and spasm ; when sudden pain
runs up along the oesophagus to the throat, strikes di-
rectly across the region of the stomach, and doubles up >
the patient, as if he had got a blow in the pit of the
stomach ; we give opium and oether by spoonfuls, ac-
companying each draught with spirits or hot Madeira ;
and follow up these by absorbent anodyne draughts, to ;
neutralize the acid and appease the pain. {

165. B:. Tincturas opii 5iv.

lavendulse ^ss.

Aquas menthas piperitas
Syrupi citri aurantii 31.

Fiat mistura, cujus sumat agger initio cochlearia quatuor,
postea duo, quater vel saepius in hora.

• anodynes for gastrodynia.

.285

166. R. Subcarbonatis ammonije gr. iv.

Opii gr. ii.

Conservas rosae gr. vi.

Ut fiat bolus vel pilulae moUes duo, statim sumendas, ef
secundum gradum doloris repetendae, comitante sem-
per subcarbonata, congrua quantitate aquse.

167. R. Carbonatis calcis 9ii.

Pulvis rhaei palmati 9i.

Mucilagihis g. mimosae hiloticaei
Syrupi citri aurantii.

Aquas lauri cinnamomi aa
Tincturas opii ^ss.

Fiat haustus, statim sumendus, et repetendus quater in
die.

Applicentur lintea, tinctura opii madida, ad leniendam
dolorem ventriculi.

168. R. Magnesias 3ii-

Pulveris rhaei palmati 3i.

Aquas menthae piperitas.

Mucilag. g. mim. niloticae.

Syrupi aa ^ii.

Tincturas opii 3i-

Misce, et sumat aeger cochlearia tria magna, quater m
die.

Spasm of the neck of the bladder, requires external
perhaps still more than internal medicines.

1 69. R. Camphorae gr. viii.

Alcoholis pauxillum.

Opii gr. ii.

Conservas rosas q. s.

280 anodynes in SUrpHESSlON OF UHINE.

Ut fiat bolus, statim siimendus. Habeat statim eriertiS
anodynum, et fotum calidum.

I

••

170. B:. Seminis anethi. • .

Aiithemidis nobilis aa 31. *

Coque ex aqiije Ibiss. ad ^x.

Adde tincturag opii 3b '

Pro enemate.

’ , f ^ • • •

171. R. Decocti communis Ibiii. .i

Muriatis sodag.

— ammonisE aa 3iii*

Alcoholis 3V.

Tincturag opii 31-

Fiat fomentatio, inferiori parte abdominis applicanda#
pro h’or® spatio, et post fomentum illinatur regio pu-^
bis, sequente embrocatione :

172. R. Tincturag opii.

Olei campliorati aa Jss.

173. R. Spirit, oetlieris nitros. 3!.

Tinctur* lavendul. ^ss.

opii 5ii-

Sumat £eger 3i- tcrtia quaque bora, superbibenS emul-
sionis camphoratse cyathum.

At si aliter solatium nequit afferi, utendum est cereolo
chirm’gico, Gallice Bougie semper Algali Araborum
a!nteponendo : Introitilssum cereolum et in angustam
urethrag partem impactum, maneat paululum, et ubi
Tetrahitur, fluet urina, initio giittatim, postea pleno
rivo.

Medicines,' which relax spasm in one part or organ,
have some influence in every other : Thence Opium,
Camphor, (Ether, &:c. which alleviate spasms of the miis-

)

' antispasmodics in asthma. 287

6ular parts, relieve spasms of the neck of the bladder,
of the glottis, of the biliary ducts, &c. Yet each of these
require peculiar forms, or doses of antispasmodics, and
none perhaps are more difficult to remedy than spasms
of the glottis, such as occasion asthma, pertussis, &c.

Ipecacuanha, a powerful sedative, affects particu-
larly the opening of the larynx.

174. Ri Pulveris ipecacuanha gr. ir.

SumatUr diluculo quotidie in Asthmate.

Or, as it is prescribed by Dr Pearson ;

175. R. Aquae purse ^i.

Syrupi simpl. 5^1-

Sodae sub-carbonatis gr. xxiv^

Vini ipecacuanhse ^i-
Tincturae opii gtt. iv.

Sumat infans sextam partem, quarta vel sexta qu^ue
hora, in tussi convulsive.

Or antimony :

176. R. Tartritis antimonii gr. iii.

Aquse ^i.

Syrupi auTantii *m.

Sometimes tartrate of antimony is applied, along with
other stimulant medicines, to the scrobiculus cordis.

. }

177. R. Tartratis antimonii 9i.

Tincturse opii ^ii.

: — meloe vesicatoriae Vel,

178. R. Linimenti saponis cum opio ^iSis.

Aquse ammonise ^iv.

IVIisce pro embrocatione.

288

OF NAIICOTIC POULTICES.

EXTERNAL APPLICATIONS FROM THE CLASS OF ‘

NARCOTIC MEDICINES.

]\1any of tliose compiaints, in which Narcotics and
Anodynes are prescribed, and ahnost all those in which |
Narcotics are permanently given, require baths, fomenta-
tions, or poultices of Narcotics. We rarely indeed hope
for any tiling beyond present ease ; it is as anodynes only j
that we use such decoctions, and poultices, in diseases too j
dreadful to allow any hope of cure. In the more despe-
rate cases of rheumatism, we use such anodyne applica-
tions ; in venereal nodes, and wide-spreading ulcerations
of the skin, and glands ; in schirrhous diseases of the
testicle, or mamma ; in open ulcerations of a cancerous
natiu-e, on the penis, testicle, or eye ; in cancerous ulcers j
of the bladder, of the womb and vagina, of the rectum,
or the verge of the rectum.

Cicuta and Digitahs, for all the more desperate and
painful diseases, are most resorted to. Tliat form of ap-
plication most natural to the untaught and vulgar,
though least used, is assuredly the best, viz^ to take the
fresh leaves of the hemjock, bruise them with the back
of a spoon, till the juice exude, and apply them to the i
sore. This I Can assure the tyro, that hemlock and fox-
glove thus applied to unseemly cutaneous eruptions, scab-
by and idcerated skin, has admirable effects. But if it ,
must be used in a more scientific form, this is the best.

IT-f. R. Foliarum recentium conii maculati, seli-
bram ; vel,

Fulveris foliorum siccatorum uncias tres.

Aquae libras duas cum semisse ; ooque ad libras duas,

vel durante semihor

• HEMLOCK POULTICE.

289

This is the fomentation which we apply hot, morning
and evening, for half an hour or more at each time, in
the worst venereal nodes ; in rebellious sores in the groins
or on the penis ; in open cancer of the mamma, or ra-
ther of the axilla, for the disease has reached the axilla,
and the whole arm is tumid, before we come to this last
resource for ease and rest. It serves also as an injection
for the cancerous womb, or rectum.

I never suffer the decoction of cicuta to be strained ;
and when the operation of fomenting is concluded, co-
ver the face of the sore with a brtiised leaf. - Such ano-
dyne fomentations, alternated with caustics, - will some-
times cure sores apparently desperate. The caustic is
appUed with ■ a camel’s hair pendl, every morning, or
every second motning, boldly- and perseveringly. The
caustic, when it runs down over sound parts, is to be
soaked up vsdth a sponge, dipped hi warm milk, and
kept ready in the hand. The sore, after cauterizing, is
sometimes left dry, and powdered vdth carbonas zinci.
The fomentation is to be applied again in the afternoon
and evening. This is the best process of the more suc-
cessful quacks.

The hemlock poultice is made of this fomentation,
thickened with flour, or linseed meal, to which should
be joined a proportion of the dry powder.

180. R. Decocti conii maculati Ibi.

Pulveris conii ^i.

seminum lini usitatissimi q. s.

Ut formetur cataplasma, sine interv^entione lintei appli-

canda, post fomentum ; vel,

181. R. Fol. conii maculati exsiccati.

Medullae panis aa partes sequales.

Aquas q. s.

VOL. III.

T

290

POULTICE OF DIGITALIS.

Ut coquantur simiil, in massam mollem pro cataplas-
mate.

I

I

A narcotic stUl more useful in active inflammations,
and one which I more frequently use in cutaneous ul-
cerations, is the fomentation and poultice of fox-glove.

* .*■■*'. • . .

182. R. Pulveris foliorum digitalis purpureae un-

cias tres.

Coque in aquae libris duobus ad unam, pro fotu, ad-^
misce q. s. vel pulveris lini, vel medullae panis, ut
fiat cataplasma anodynum.

183. R. Farinae avenae sativae selibram.

Fohorum recentium conii maculati rite con-
tusorum uncias dims.

Aceti q. s. Coque parumper et adde,

Muriatis ammonias semiunciam.

1

■Ut fiat cataplasma anodynum resolvens. . -

Among anodyne medicines, rather than anodyne ap-
plications, we must rank as a very important one in-
deed, the anodyne glyster, which remarkably aids the
operation of internal anodynes, and often supplies their
place most happily, when perpetual vomiting would
prevent anodyne draughts from being retained.

184. R. Aquas, vel lactis tepidse uncias quatuor.

Tincturas opii 5i- ad 3iii-
Fiat enema anodynum.

This is properly another manner of exhibiting opium ; (
but that which I am now to speak of, if not an external, 1
is at least a topical application, and a very precious one.

INJECTIONS FOR DISEASED BLADDER.

291

185. R. Amyli 5ii- solve in

Aquas ferVentis
Extract! cicutae gr. iv.

Fomentatio anodyna tepide in vesicam urinariam in-
jicienda, ope catheteris ; vel,

186. R. Lactis tepidi

Tincturae opii 51-

Injectio in irritabilltate vesicse ; vel,

187. Ri Acetatis plumbi 3ss.

Aquas rosas.

■ — distillate aa 5m.

Tincture opii ^iss.

M. ut fiat injectio.

188. R. Extract! hyoscyami nigri 5i*

Camphore gr. xii.

Opii 9i. ; misce ope alcoholis pauxfllumi
Ut fiat pulpa anodyna, ulceribus cutis applicanda, ope
penicUli.

189. R. Pulveris foliorum hyoscyami nigri

Succi conii maculati 31*

Adipis suille

190. R. Adipis suillffi

Opii 3ii-

Fiat unguentum.

I

191. R. Opii 3ii.

Cauiphore 3s^-
Adipis suille 3"'^*

Misce, ut fiat unguentum.

293

ANODYNE EMBROCATIONS.

192. R. Camphorae ^ss.

Olei oleae Europsese
]\fisce, fiat embrocatio ; vel,

193. R. Extracti hyoscyaird 5iii«

Pulveris foliomm conii maculati
Camphoras ^ii.

Olei terebinth, q. s.

Ut fiat massa mollis leni frictione applicanda, tumoribus
strumosis glandularum conglobatamm cervicis, et
maxiUae ; intumescentibus glandulis thyroidis ; tumo-
ribus hydropicis articulorum ; ulceribus cancrosis prae-
cipue narium, genarum, &c.

Emplastrum opii.

Tinctura opii, £cc.

Oleum camphorxitum, &c.

Tinctura saponis cum opio.

And other pharmaceutical preparations, are the more fa-
miliar anodyne applications. The camphorated poultice
is especially useful ; it is made by pouring over the com-
mon emoUient poultice, a quantity of the camphorated
oil, mixing it up with the poultice, and still adding more
oil, to cover well the surface of the poultice, which should
be applied hot. Or the hemlock, or henbane poultices,

may be covered with strong camphorated oil.

.1

RETROSPECTIVE AND GENERAL VIEW OF THE CLASS
OF NARCOTIC MEDJCINES.

I lament at every step, the difficulty .of giving a clear,
rational, and simple view of the several properties of me-
dicines ; and the disappointment I feel arises from these
quahties having their relations to the complicated me-

RETHOSPECT OF NARCOTICS.

293

ehanism of the animal body. Yet I trust the young
physician will find his talent of appropriating remedies
to diseases, improved, by the arrangement I have made,
and will, in the course of practice, improve these ar-
rangements, or substitute a system of his own, so as to
be able to distinguish the various dangers of disordered
and violent action, and how to subdue them. He will
infer fi’om the observations interspersed with these pre-
scriptions, that narcotics and antispasmodics hold a dis-
tinguished place among the remedies calculated to regu-
late and moderate both the actions of the vascular, and
the feelings of the nervous or sentient part of the animal
system : and he will perceive, although no such arrange-
ment is absolutely set down, that the several narcotic
remedies are destined to almost specific purposes, or pe-
culiar disorders.

1st, That Digitalis, variously combined with sedatives,
and with other narcotics, to enforce its operation on the
animal system, is usefiil in inflammatory actions, and in
the diseases of the more precious organs, which it saves
by moderating the intensity of action, as in Delirium,
Insanity and Fury, Hydrocephalus, Phthisis, Rheuma-
tism, and Dropsy, arising from disease in the abdomi-
nal viscera.

2d, That Hyoscyamus, Conium Maculatum, and
Opium, narcotics of the highest class, are used in those
dismal cases, where painful actions, diseased bladder,
(e. g.), are- to be moderated, and diseases quite incm-
able are to be assuaged. It is in Glandular swellings.
Tumors, diseases of the Bladder and Rectum, Venereal
pains, and cancerous sores ; in Tic doloreux, and other
intolerable pains, that such narcotics are prescribed:
with the recollection still, that these are also pre-emi-
nently seiwiceable in reinforcing the powers of other
narcotics, or in modifying the effects of other remedies.

294* RETROSPECT OF NARCOTIC MEDICINEI?.

It must not be forgotten, that all intense actions arise
from increased sensibility, that pain is itself a cause of
increased action, and is by nature appointed as an indi-
cation of danger and disorder.

3c?, Opium is a medicine of such moderate power,
and with qualities combined so kindly, as to afford
us familiar remedies for all common disorders, and an
qasy solace in painful diseases. This is the medicine
that requires the most varied combination to bring out
its medicinal powers. Its uses are infinite : To promote
sleep in diseases so slight, as to be little remote from the
healthy condition : As a cordial and anodyne in febrile
diseases, at once supporting the strength, and abating
the intensity of arterial action : In all disorders of the
alimentary canal, especially in cramp of the stomach,
holera morbus, diarrhoea, dysentery: In restraining

mucous discharges, as in cough, gonorrhoea, and fluor
albus ; or discharges of blood, as hasmatemesis and hoe-
moptysjs, menorrhagia, abortion, child-bed flooding.
Whether it is useful as a narcotic in such diseases, or
should rather be arranged with astringents, I know
not, I care not, it is a question of very trivial import-
ance in any practical view.

Uh, Antispasmodics are the same powerful remedies
used to abate, not vascular action, or painful sensations,
but muscular contractions, and especially contractions of
the sphincter muscles. The same narcotics are used as
antispasmodic in trismus, epilepsia, hysteria, and hydro-
phobia ; but conjoined with remedies peculiarly adapted
to each individual case ; as oether, ammonia, and ipeca-
cuanha, in asthma ; tartras antimonii, and ipecacuanha,
along with cicuta, for hooping-cough : valerian and
mosch, for hysteria ; camphor, for affections of the uri-
paiy passages.

‘ How much the external use of narcotic medjj-

OF EMETICS.

295

CINES aids their internal operation, in inflammation, ul-
cerations, and cancer, gout, rheumatism, and other dis-
eases, is too little thought of. " ‘

Emetics.

■ 194. R. Vini ipecacuanhas unciam
Pro emetico.

195. R. Pulveris ipecacuanhse 9i.

Pro emetico.

196. R. Pulveris ipecacuanhas ^i.

Tartris antimonii gr. i.

Misce ut fiat pulvis emeticus.

197. R. Tartritis antimonii gr. iv. ; solve in

Aquae distillatae ^iv.

Fiat solutio, cujus sumat aeger cochlearia magna duo
quater in hora pro emetico : — sed si pro cathartico, vel
ad perspirationem excitandam, habeat cochleare bis in
hora.

198. R. Pulveris ipecacuanhas 5iss.

Supertartratis potassae
■ Aquae ferventis ^iii.

Macera per horam, dein cola, et adde syrupi
^umat asger cochlearium amplum omni semihora, donee
evomuerit, in diarrhoea, dysenteria, &c. :

{

199. R. Sulphatis zinci 9iss.

Conservae rosae q. s.

Ut fiat bolus, contra venenum adhibendum : superbiba-
tur statim, aquas tepidas cyathum, et post singulas
vomitiones, haustus infusionis anthemidis.

296

EMETICS OP SQUILLS.

To childi’en labouring under the hooping-cough, or
suffocating with croup, we give two drachms or more
of tinctura ipecacuanhse, from time to time, or three
grains of the powder of ipecacuanha ; and still more
commonly do we prescribe sickening doses.

200. Be. Vini ipecacuanhse ^ss.

Oxymelhs scillae

Capiat cochleare minimum omni bora ; vel,

201. Be. Tincturse scillse 5iss.

Oxymellis scill® Pharm. Lond. 5^-,

Aquae distillatae Jiss.

Misce, capiat cochleae minimum omni hora.

202. Be. Liquoris tartratis antimonii ^ii.

Aquae distUlatae 3iss.

Oxymellis scillae 5SS.

Sumat cochleare minimum subinde, ad nauseam vel vo-
mitum promovendum.

OF PURGES, LAXATIVES, AND ANTHELMINTICS.

m

First, — Saline purges.

203. Be. Sulphatis sodae 3!.

‘In aqua, mane sumendus.

204. Be. Tartratis sodae et potassae 5vi.

Aquae ^xii.

Fiat solutio, mane sumenda.

/

205. Be. Tartratis sodae et potassae 3i.

In jusculi bovini libra soluta, partitis vicibus sorbenda.

SALINE PURGES.

206. R. Phosphatis sodae ad |iss. ...
Sumatur mane, in jusculo bovino, partitis vicibus.

207. R? Sulphatis sodiE 5’'^^*

Solve in aquae menthae piperitis '^vr,

Fiat haustus purgans, duabus vicibus suihendus.

• 208. R. Tartritis potassae et sodae Ji,

Mannae ^u. .

Aquae ferventis ^vi. ^ ■

Aquae lauri cinnamomi ^ii.

Syrupi citri aurantii ^i.

Fiat haustus purgans, partitis vicibus sumendus.

209. R. Supertartritis potassae ^iii.

Mannae Jss.

Aquae ferventis ^vi.

Ut fiat solutio purgans, mane sumat dimidium, et post
duas horas altera pars.

210. R. Tartritis potassae 5vi.

Mannae 5ii- solve in
Aquae ferventis ^iii- adde
cinnamomi Jiii.

Ut fiat solutio cathartica, duabus vicibus sumenda.

These gentle saline purges require to be sharpened
by the addition of jalap, senna, or some other resinous
purge; and sometimes to be made acceptable to the
stomach, by the addition of some warm medicine.

211. R. Tartratis sodae semiunciam.

Foliorum cassiae sennae drachmas duas.
Extracti glycyrrhizae glabrae drachmam.
Aquae ferventis uncias duodecim.

Fiat infusum, quatuor vicibus sumendum.

298 SALINE PURGES WITH SENNA, &C.

212. R. Sulphatis magnesise drachmas sex.

Infusi cassi® senn® uncias duodedni,

Syrupi aurantii unciam.

Fiat haustus purgans, mane sumendus.

213. R. Sulphatis magnesias drachmas sex.

Supertartritis potassae drachmas duas.

Infusi cassias sennae uncias duas.

Aquas cinnamomi Jvi.

Solutio cathartica, duabus vicibus primo mane sumenda,

214. R. Sulphatis magnesiae

Aquae menthae piperitis ^vi.

Tincturae convolvul. jalapae ^ii.

Sumantur cochlearia tria magna in horis, donee alvus
rite respondeat.

215. R. Sulphatis magnesias ^ss. /

Infusi cassias sennae 5ii.

Tincturae sennae.

Syrupi zingiberi aa 5ii-
Fiat haustus purgans.

216. R. Sulphatis magnesias solve in

Infusi sennas ^i*

Fiat haustus, altera quaque hora sumendus, donee alvus
. soluta fuerit.

217. R. Tartritis potassae ^ss.

Mannae 5ii*

Aquae ferventis ^^iii.

Tincturae jalapae ^ss.

Aquae menthae piperitis ^iii*

IMisce pro solutione cathartica, dimidium pro dosl.

SALINE PURGES WITH SENNA.

299

218. Be. Tartritis potassae et sodae 5'^* solve in

Aquas menthas piperitis.

— cinnamomi aa

Syrupi zingiberi
OEtheris sulphurici.

Tincturae lavendulae aa

Sumantur cochlearia tria, bis in bora, donee alvus respon-
dent.

219. Be. Sulphatis magnesiae unciam.

Infusi sennas uncias quinque.

Syrupi zingiberi unciam semisse.

Fiat mistura, cujus sumantur cochlearia duo bis in hora,
donee alvus respondent.

220. Be. Phosphatis sodas

Infusi sennae ^iv.

Tincturas sennae 5ii.

Syrupi zingiberi ^i.

Fiat mistura, cujus capiat aeger jmtem tertiam, dpn^ic
alvus rite respondeat, bis in hora.

There are many kinds of bad health, especially a ten-
dency to inflammatoiy, cutaneous, eruptive diseases, op
affections of the alimentary canal itself, which require
that saline purges be repeated daily. These ape usually
prescribed in form of powders, which the patient, dis-
solving in a glass of cold water, takes every morning,
as he would a draught of any mineral purging water.

221. Be. Super-sulphatis potass* ^ii.

Supertartritis potassas 5^^.

Sulphatis ferri 5ss.

Tcre simul diligenter, ct divide in partes duodecim

soo

RESINOUS PURGES.

asquales, quarum sumatur una prime mane quotidie,
in aquae cyatho soluta.

222. R. Sulphatis magnesi® drachmas tres.

Supertartritis potass® drachmam unam.
Misce, sumantur omni mane in aqu® unciis sex vel
octo.

223. R. Super-sulphatis potass® drachmam. ,

Pulvis rh®i palmati grana quindecim.

Fiat pulvis, quotidie mane sumendus.

Second, — Submurias hydrargyri, and resinous

PURGES.

224. R. Pulveris jalap® compositis 5ii-
Fiat pulvis catharticus, primo mane sumendus.

225. R. Pulveris jalap® compositis unciam.

Divide in doses sex, sumat ®ger pulverem, altera quaque

hora.

226. R. Pulveris jalap® compositis unciam.

Sumatur cochlearium parvulum ter in die.

227. R. Pulveris jalap® compositis drachmas duas,

in pulveres tres divisas.

Sumat ®ger unam statim, vespere sumat alteram, et ter-
tiam primo mane, si lente, vel non omnino respon-
derit alvus.

#

228. R. Pulveris jalap® compositis drachmas duas,

in doses tres divisas.

Sumat unam altera quaque hora.

JALAP AND CALOMEL.

301

229. R. Pulveris jalapse

Sacchari rubri 9ii.'

Pulveris aromaticae 3i-

Tere simul, ut pulvis catharticus, in doses sex dividenda :
adhibeatur pulvis donee dejiciatur alvus, ad trium ho-
rarum intervallum.

230. R. Pulvis jalapas scrupulum.

' Supertartritis potassse drachmam*

Fiat pulvis ex syrupo sumendus. *

< ■ U

231. R. Submuriatis hydrargyri grana octo. ,

Sacchari purificati 9i.

Pulveris ‘corticis cinnamomi gr. X.'* .1

Fiat pulvis purgans, mane sumendus : Si opus sit, inji-
.. ciatur enematis domestici libra. . ,

232. R. Submuriatis hydrargyri grana duodecim.

Sacchari drachmam.

Tere intime, et divide in doses quatuor, mane singulis
horis sumendas.

* »

233. R. Submuriatis hydrargyri drachmam dimi-

diam.

Sacchari albi drachmam.

Optime terantur, et in pulveris asquales sex dividantur ;
sumat aeger pulverem singulis horis usque ad quintam,
nisi alvus prius dejiciatur.

234. R. Submuriatis hydrargyri scrupulos duos.

Sacchari puri drachmam.

Tere intime, et divide in doses duodecim ; sumat imam
altera quaque hora. '

302

PILLS OP CALOMEL AND JALAP<

235. R. Submuriatis hydrargyri grana sex.

Pulveris convolvulas jalapjc scmpulum.
Sacchari puri gr. xv.

Olei cinnamomi gtt. iii.

Fiat pulvis catliarticus.

236. R. Submuriatis hydrargyri gr. xv.

Pulveris baccas capsicas gr. vi. s

. Sacchari 5i-

Olei canii gtt. iv.

Misce, et divide in doses tres, tertiis horis sumendas, ad
trium horarum intervallum.

237* R. Submuriatis hydrargyri grana duodecim.
Pulveris jalapse semidrachmam.

Simul terentur, et dividantur in doses quatuor aequales^
quarum sumatur una interpositis tribus horis.

238. R. Subcarbonatis hydrargyri grana quindecim.,

Pulveris convolvulae jalapse scrupulum.

Fiat massa mollis, in duos bolos dividenda, quorum su-
mat unum statim, post tres horas habeat alterum ; al-
vo reddita, sumat vespere haustum anodynum.

239. R. Submuriatis hydrargyri grana octo.

Pulveris jalap® scrupulum.

Olei pulegi gmttas quatuor.

Mucilaginis gum. mimos® nilotic®,
quantum satis sit, ut fiant pilul® sex ; tres vespere, treff
summo mane sumend®.

240. R. Submuriatis hydrargyri grana decem.

Conserv® ros® grana decem, vel q. s.

Ut fiat bolus,* statim sumcndus : Superbibatur, infusi
senn® uncias duas.

senna infusion.

303

241. R. Submuriatis hydrargyri gr. vii. ’ ■ ’

Pulveris rhaei palmati gr. x.

Mucilaginis gum. mim. niloticae, q. s.

TJt fiat bolus catharticus.

These are the medicines by which we procure, not
only evacuation of the bowels, but the sedative effect of
those medicines, and that profuse secretion from their
internal surfaces, which is useful to the restoration or
preservation of health. The purges we have prescribed ■
are of themselves availing, and are gentle in their ope-
ration ; but when they fail in tlieir ordinary operation,
and we begin to be anxious about procuring evacuation,
and wish to ensure it, w'e prescribe an additional cup of
some purging infusion, as of senna, or of rhubarb, but
chiefly of senna.

242. R. Foliorum cassiae sennae sescunciam.

Seininum anisi semiunciam.

Supertartratis potassae drachmas duas.

Aquae libram.

Supertartratem potassae, in aqua coque, postea liquorem
, adhuc ferventem, sennae seminibus affunde : Sumat
aeger uncias duas vel tres, pro prima dosi, dein vero
quavis hora unciatim, donee alvus semel iterumque
' ducta fuerit.

243. R. Foliorum cassiae sennae drachmas tres.

Supertartratis potassae.

Extracti glycyrrhizae glabrae singulorum
drachmam unam.

Infunde per horae spatium, in aquae fervidae unciis duo-
decim : Sumatur infusi colatae partem quartam secunda '
quaque hora, ad promovendam operationem pulveris
cathartici. Vel;

304

OP CASTOR oiT.

Sumatur vespere bolus catliarticus, submuriatis Iiydrar-
gyri : mane, sumatur altera quaque bora, nisi prius
respondeat alvus, cyatlium infusae sennae. V el,

244. R. Pulpae tamarindorum semiunciamw

Foliorum cassiae sennae 5ii-
Aquae ferventis 5X. ; infunde et cola, dein
adde,

Syrupi'aiu'antii 5iss.

Fiat infiisum, cujus sumantur unciae duae secunda qua-
que bora.

245. R. Pulpae tamarindorum undam.

Senunum coryandri.

Saccbari purissimi.

Foliorum cassiae sennae aa 5ii*

Aquae buUientis uncias sex ; cola, et adde.
Aquae laiui cinnamomi ^ii.

Sumantur cocblearia quatuor, et repetantur donee re-
spondeat alvus.

But when we become more anxious to restore the ac-
tion of tbe intestines, than to procure evacuation ; when
we fear, lest dangerous constipation terminate in dan-
gerous colic, and yet do not cboose to have recourse to
drastic purges, (milder purges are indeed tbe most avail-
ing in those circumstances), we cboose tbe following :

/

246. R. Olei ricini ^i.

Mucilag. g. m. niloticae.

Syrupi zingiberi aa ,^ss.

Aquae mentba? piperite 51.

Sit pro baustu catbartico.

TINCTURE OF JALAP.

305

247. R. Olei ricini Jii.

Mucilag. g. m. nilotiae 3SS.

Syrupi zingiberi.

Aquas lauri cinnamomi aa
Olei menthas piperitas gtt. x.

Fiat mistura cathartica, cujus sumat asger dimidiam pn-
mo mane, alteram partem, si opus erit, post boras tres
quatuorve.

*

248. R. Olei ricini.

Syrupi zingiberi.

Aquae lauri cinnamomi spirituos. aa Ji.
Haustus mane sumendus, superbibens infusi sennas un*
cias duas, omni bihorio.

249. R. Olei ricini 5ii.

Mucilaginis g. mimosas nUoticae ^i.

Aquas cinnamomi 5!.

Tincturse convolvuli jalapse 5SS. ; misce.
Sumat dimidium pro dosi.

250. R. Tincture jalapas drachmas sex ad unciam.

Aquae menthse piperitae.

Syrupi zingiberi aa semiuiiciam.

Fiat haustus, statim sumendus.

251. R. Tincturee convolvuli jalapae 5!.

Syrupi drachmas sex.

Fiat haustus, mane et vespere sumendus': haustui ves-
pertine instillentur, tincturas opii guttas viginti.

252. R. Tincturae convolvuli jalapae uncias duas.

Syrupi simplicis unciam.

Aquae uncias duas.

Sumat asger singulis horis cochlearia duo.

VOL. III. u

306

TINCTURES OF SENNA AND JALAP.

253. Be. Tincturae convolvuli jalapae.

Syrupi simplicis aa uncias tres.

Sumatur cochleare magnum singulis iioris.

254. Be. Tmeturae convolvuli jalapae.

Aquae fontanae. ^ ‘

Syrupi utrinque unciam.

Fiat haustus catharticus, primo mane sumendus.

255. Be. Infusi cassias sennae uncias decern.

Tincturae convolvuli jalapae uncias duas.
Extracti glycyrrhizi glabri drachmam.

Fiat infusio, cujus sumantur unciae duae singulis horis.

256. Be. Pulveris convolvuli jalapae drachmam.

Carbonatis magnesiae drachmas duas.
Mucilaginis gummae mimosas niloticae.
Syrupi zingiberi aa semiunciam.

Probe mistis alFunde, aquae uncias quinque.
Mistura agitata, sumatur uncia, secunda vel tertia qua-
que hora.

257. Be. Tincturae convolvuli jalapae ^ii.

Sacchari purissimi 5SS.

Aquae ^iv.

Sumat aeger cochlearia duo ad trium horarum intervallo.

258. Be. Tincturae cassiae sennae ^i.

Vini aloetici ^ii.

Aquae menthae piperitae 5iii.

Syrupi zingiberi ^i.

Misce; sumantur cochlearia qilatuor, vel unciae duae^
secunda quaque hora.

But when we become extremely anxious to move the

ELECTUARIES OF SENNA AND JALAP.

307

bowels, as in constipation, colic, and ileus, we use more
drastic purges ; and lest the sickly stomach should re-
ject them, we give them in the more compendious form
of pills ; and in proportion as we seem to fail, and the
circumstances of the patient become critical ; when the
pains and tortures of colic increase, and the bowels are
still no way affected by our medicines, we combine the
various cathartics, the calomel, aloes, jalap, gamboge,
and colocynth in large doses ; and give draught after
draught, and pill after pill, till we procure evacuations ; -
aiding their operations, both by copious draughts of sen-
na, and by irritating at the same time the lower part of
the bowels with stimulant injections.

Among the first, most acceptable, and often the most
effectual of these, is an electuary, composed of the pow-
ders of senna and jalap with cream of tartar.

259. R. Supertartritis potassas

Pulverls convolv. jalapae

Zingiberi ^i*

Confectionis aurantii, q. s.

Ut fiat eectu arium, cujus sumat asger cochleare me-
dium, ter quaterve singulis horis, donee alvus copiose
respondeat.

260. R. Electuar. cassiae sennse ^iss.

Pulveris convolv. jalap. 5hi-

Supertartritis potassse 5SS.

Syrupi zingiberi quantum satis.

Ut fiat electilarium, cujus sumaritur initio cochlea-
ria magna quatuor, dein cochlearia duo secunda qua-
que hora, donee rite purgetur al\uis.

GAMBOGE.

.S08

261. R. Supertartritis potassae 5!.

Pulveris foliomm cassiae senna*.

Pulveris convolvuli jalapae aa 3ii-

Confectionis aurantii 3SS.

Fiat electiiarium, cujus sumantur initio cochlearia mini-
ma tria, postea cochlearia duo, singulis horis, donee

alvus solu^a fuerit.

Third, — Of resinous and drastic purges.

It is to be recollected, that gamboge, elaterium, and
calomel, are preferable as hydragogues : that aloes, colo-
cynth, scammony, and calomel, are preferred in obstruc-
tions of the ahmentary canal : and finally, that I prescribe
them here in the succession in which they are marked
down, in the prehminary view I have given of the ma-
teria medica. Almost each of the following prescriptions
is equally applicable to the following important purposes.

1^^, To move the bowels in cases of dangerous con-
stipation, cohe, and ileus ; and with this view, opium is
introduced into several of the forms of prescription, to
appease the spasm, and prepare the intestines for resmn-
ing their natural action.

2«Z, To aid in clearing the bihary ducts, in which ope-
ration, the addition of opium is not a little useful.

3c?, In procuring very profuse secretion from the
surfaces of the intestines, in dropsy, for example.

262. Be. Gambogiae gr. v.

Supertartritis potassas

Sacchari puriss. gr. x. m ; terito simul,

Ut fiat pulvis, ter in die repetendus.

GAMBOGE AND JALAP.

309

263. R. Gambogije gr. iii.

Pulveris jalapae compositas 3ss.

Sacchari albi

M. ut fiat pulvis catharticus.

264. R. Gambogiae gr. iv.

Submiiriatis hydrargyri gr. vi.

Sacchari.

Pulveris aromatici aa '

Fiat pulvis. . '

265. R. Gambogiae scrupulum unum,

Saponis grana quindecim.

Mucilaginis G. M. Niloticae quantum satis,
Ut fiant pilulse sex granorum ; sumat seger duas singulis
horis.

266. R. Gambogiae gr. v.

Supertartratispotassae^i.; terito beneet adde
Tincturae jalapae 5ss.

Sy rupee aa ^ii.

Aquae rosae aa ^ii.

M. ut fiat haustus catharticus.

267. R. Gambogiae gr. iii. ; terito bene cum,

Tincturae sennae compos, ^ss. ; adde,

jalapae 5ii*

Syrupi zingiberi 5ih.

Misce pro haustu cathartico.

268. R. Gummi gambogiae gr. xv.

Supertartratis potassae.

Sacchari purificati.

Pulveris cinnamomi aa ^i. terito simul op-
time, dein adde,

Syrupi zingiberi.

Aquae menthae piperitae aa |iii.

310

SCAMMONY AND JALAP.

Ut fiat mistura cathartica, cujus sumatur tertia pars sin-
gulis horis.

)

269. R. Gambogiee gr, iii. ; terito cum

Tincturas sennas
Syrupi simplicis 5!.

Fiat haustus purgans.

It is to be obsei'ved, that aloes, from operating on the
lower intestines chiefly, is slow of operation, may be
taken over night, the effect being expected in the morn- ,
ing, and ensured then by an additional pill ; that aloes ,

is thence used more as a laxative, than as a purge ; but j

combined with calomel, colocynth, scammony, &c, to !
quicken its' operation, it is a most powerful medicine,
and holds its place in almost all the various combinations
of these more drastic purgatives. ^ '

270. R. Convolvuli scammonias gr. xii. . '

Pul veils convolvuli jalapie. ;

Supertartritis potassas. 1

Sacchari puri aa 9i-
Pulveris zingiberi gr. x.

Fiat pulvis catharticus, partitis vicibus sumendus.

271. R. Convolvuli scammonias gr. xii.

Submuriatis hydrargyri gr. vi.

Supertartritis potassae 3ss-
Pulveris zingiberi gr. v.

Fiat pulvis catharticus.

272. R. Convolvuli scammoniae.

Pulveris convolvuli jalapas aa gr. xv.

Pulveris aromaticee gr. x. .

Fiat pulvis purgans.

COLOQUINTIDA, CALOMEL, AND GAMBOGE. 311

273. B:. Extract! colocyntliidis compositi

Submuriatis hydrargyri gr. xii.

Fiat massa in pilulas duodecim jequales dividenda, qua-
rum sumat aeger duas secuiida quaque bora, donee
alvus bis terve respondeat; superbibendo cochlearia
tria magna infusi sennae.

274. R. Extract! colocyntliidis gr. xv.

Submuriatis hydrargyri gr. iv.

Gambogiee gr. vi.

Olei carui gtt. ii.

Mucilaginis acaciae q. s. • '

Ut fiant pilulas viii. quarum sumantur statim tres, et
singulis sequentibus horis duse.

275. R. Extract! colocyntliidis 9i.

Opii gr. i.

Fiat massa, et divide in pilulas quatuor ; sint pro dosi, et
post aliquot horas, sumatur infusionis senna, (ad-
jecta tincturae sennae quartam partem), cochlearia duo
magna, singulis vel alternis horis usque dum dtjec-
tionum satis fuerit.

\

276. R. Colocyntliidis grana quinque.

Supertartritis potassae.

Convolvuli scammon. aa 0ss.

Aloes gr. xii. ; tere simul et adde,

Olei menthae piperitae gr. vi.

Mucilaginis gummae tragacanthae q. satis, ad formandam
massam, dividendam in pilulas octo, quarum sumat
aeger quatuor statim, et postea pilulas duas singulis ho-
ris, donee solvetur alvus. i

The mass, of pilulae aloes cum colocynthide, is com-
posed of scammony, aloes, and colocynth, in such pro-

312 COLOCYNTH AND GAMBOGE.

portions, that half a drachm of the compound mass, di-
vided into five grain piUs, makes six pills, containing
five grains of colocynth, ten of aloes, and ten of scam-
mony. These, like the other compound resinous pills,
are equally used as hydragogues, and for resolving dan-
gerous obstructions of the intestines. i

277. R. Pilulas aloeticas duodecim.

Sumantur tres secunda quaque hora, donee rite respon-
deat alvus.

278. R. Pilulas aloes cum colocynthide sex.

Singuli pendentes gr. v.

Sumat £eger duas, secunda quaque hora, superbibens
post meridiem, cyathum infusionis sennas, si opus erit.

279. R- Extracti colocynthidis grana quindecim.

, Submuriatis hydrargyri gr. vi. '

Mucilaginis q. s.

Ut fiant pilulse iv. pro dosin.

280. R. Extracti colocynthidis compositi.

Supertartratis potassse aa 0i. ; tere bene si-
mul, et adde,

Emulsionis Arabicae ^hi*

Pro haustu cathartico.

281. R. Extracti colocynthidis compositi.

jalapae aa 5i-

Gambogiae gr. x.

Olei juniperi gr. iv.

^ucilaginis q. s. ut fiant pilulas duodecim, quarum car
piantur tres singulis horis, donee alvus ter quatem'^e
respondeat.

aloes. — CALOMEL. — HELLEEORE.

313

282. R. Pilularum aloeticarum cum coloquintide,

numero quindecim.

"Sumantur pilulas tres singulis horis, donee dejiciatur al-
vus ; et pilulis sumptis, injiciatur per anum, decocti
communis libram, pro enemate, ni alvus plene soluta
fuerit.

283. R. Gummi aloes drachmam,

Submuriatis hydrargyri.

Saponis singulorum scrupulum.

Mucil. g. m. nil. quantum satis, ut fiat massa, quam di-
vide in pilulas viginti asquales, quarum sumat duas
altera quaque bora.

284. R. Extract! elaterii, Ph. I^ond. gr. vi.

Opii gr. ii.

Supertartratis potassse.

Sacchari purificati aa 9ii.

Tere simul diligenter, et divide in pulveres decern ae-
quales, quorum sumat hydropicus unam singulis bo-
ris, donee supervenerit catharsis.

285. R. HeUebori nigri.

Tartratis potassa? aa 3ii.

Foliorum cassiee sennse 3iv.

. Decoque cum aqu£e purge libra, ad colaturas uncias de-
cern adde, Syrupi zingiberi exhibeantur coch-
learia duo aut tria, sexta quaque bora, vel ter in dieJ

This is a medicine at once powerfully cathartic, and
powerfully sedative, i. e. allaying spasm, and lowering
the pulse ; it was a chief medicine with the ancients for
the cure of mania.

I

314,

LAXATIVES OF RHUBARB.

286. R. Aloes gr. xv.

Submuriatis hydrarg}^ri.

Pulveris aromatici aa gr. x.

Mucilaginis q. s. ut fiat massa, dividenda in pilulas octo ;
sumantur duae singulis horis, donee alvus soluta fiierit.

Of Laxatives.

Laxatives are not merely smaller doses, nor different
forms of these drugs, but medicines rarely used as ca-
thartics ; rhubarb for example, magnesia, manna, senna
in powder, sulphur, &c. medicines wliich are so little ca-
thartic, as to be prescribed even in dysentery.

The Compound Rhubarb Pills, are the laxative most
frequently used in debility, or torpor of the alimentary
canal : They combine the properties of aloes a stimu-
lant, rhubarb an astringent, and oil of peppermint a
warm stomachic ; and these properties are such as to
prove stomachic, and laxative, and peculiarly useful in
dyspepsia, in hypochondriasis, and in uterine complaints.

287. R. Pilulas rheei compositas duodecim.
Sumantur quatuor mane vel vespere, vel bis in die. si

opus erit.

288. R. Pulveris rhasi palmati jiv.

Supertartritis potassae.

Pulveris cinnamomi aa 5ii-
Aquae ferventis ^ii.

JMacera per duodecim horas, cola, et adde alcoholis di-
luti ^ss.

Hujus infusi sumantur cochlearia duo magna, ter in die.

289. R. Pilulas aloeticas duodecim.

Sumantur duae altera quaque hora, donee rite respon-
deat alvus, vel tres mane et vespere. ,

f HHUBARE WITH AROMATICS.

315

290. R. Pilulas aloeticas triginta.

Sumantur pro re nata tres vel quatuor vespere.

291. R. Carbonatis magnesiae ^iss.

.. Supertartratis potassse.

Sacchari utriusque

Pulveris fruct. capsid indici gr. iv.

Fiat pulvis, omni mane sumendus.

r

292. R. Carbonatis magnesiae.

Pulveris rhaei palmati utriusque 9i.

Fiant pulveres tales, duodecim ; sumatur una altera qua-
que bora, in aquae menthae uncia cum semisse, donee
fluat alvus.

$93. R. Pulveris rhaei palmati.

aromatici aa ^i.

Fiat pulverem, quotidie mane sumendum.

■ ' . I 'W >. I - \

294. R. Pulveris rhaei palmati 5ss.

Supertartratis potassae j, .

Fiat pulvis, quotidie mane sumendus. t

295. R. Pulveris rhaei palmati 9i. ^

Submuriatis liydrargyri gr. iii.

Pulvis aperiens, in quovis crasso vehiculo, mane su-
mendus.

296. R. Pulveris rhaei palmati

Carbonatis magnesiae 5iss.

Tincturae cassiae sennae.

Syrupi zingiber, aa ^i. •

Inf'usi cassiae sennae ^vi.

Fiat mistura, cujus sumat aeger cochlearia tria raagna,
altera quaque bora, donee alvus purgatur. •

816 PILLS FOR DEBILITATED STOMACHS.

297. R. Tartratis potassae 5i*

Pulveris rhaei palmati Qi. ;

Infusi cassiae sennae
Syrupi aurantii.

Tincturae amomi nepentis aa
Fiat haustus aperiens. ^

298. R. Tartratis potassae drachmam. ^

Pulveris rhaei palmati scrupulum.

Pulvis aperiens, ex syrupo sumendus. ■ • •

299. R- Pulveris rhaei palmati 5ss«

Sulphatis potassae cum sulphurae ^i.
Pulveris zingiber, gr. v.

Fiat pulvis aperiens, pro re nata sumendus.

300. R. Pulveris rhaei palmati ^i-

lauri cinnamomi compositi gr.

Signa pulvis e syrupo mane sumendus.

For gouty and debilitated stomachs, there is no laxa*-
tive piU preferable to the following.

301. R. Subcarbonatis sodae exsiccatae.

Saponis veneti.

Pulveris columbae ^ ^i. ’’

Aloes gr. vi.

Fiat massa, dividenda in pilulas octodecim, quarum su*-
mantur tres, mane et vespere.

302. R. Pilulae aloes cum myrrha gr. vi.

Pulveris fructus capsici indici gr. iir,

Fiant pilulae duae.

LAXATIVE ELECTUARIES.

317

303. R. Pulveris aloes compositi gr. X.

Olei anethi foeniculi gtt. iv.

Fiant pilulae duae.

304. R. Pulveris convolvuli jalapse.

Sacchari puris aa unciam.

Pulveris fructus capsici indici ^i.

lauri cinnamomi 5ii-

Fiat pulvis, in doses quindecim dividenda: sumatur
quotidie pulverem e cyatho aquse.

305. R. JVIannae ^iss.

Supertartratis potassae Jss.

Syrup, rosae q. s.

Ut fiat electuarium ; detur singulis horis, donee alvus re-
spondent.

306. R. Electuarii cassias sennas |ii.

Sumat aeger portionem ad instar nucis moschatae pr®
dosi primo mane, vel mane et vespere.

The Electuary of Senna, the Lenitive Electuary of the
old school, is the only form almost, (the powder being
rarely used), in which we give senna leaves, and stalks,
in substance. The purgative virtue of this electuary, it
derives from the senna leaves ; their sickening and grip-
ing effect is counteracted by adding to the powdered
senna one half their bulk of coriander seeds ; and they
are concocted into the form of electuary, by the help of,
pulps of figs, tamarinds, and prunes. But it is an electu-
ary so unpleasant to many, from its heavy mawkish taste,
and griping effects, that its place will be well supplied
by such an extemporaneous prescription as the following.

318

SULPHUR A\D CREAM OF TARTAR.

307. R. Supertartratis potassae

I’ulveris convolvuli jalapae ^ss.

Confectionis citri aurantii 5SS. vel q. s.

Ut fiat electuarium : sumantur pro dosi coclilearium, vel
cocldearia parvula duo, mane vel vespere.

308. B:. Pulpas tamarind! indici Jiss,

Pulveris rhsei palmati
Supertartratis potassae 3iv.

Syrupi zingiber, q. s.

Ut fiat electuarium.

Dosis, ^cochlearium parvum unum, vel alterum, pro re
nata.

309. R. Sulphuris ^i.

Supertartratis potassae
Pulveris convolvuli jalapae 5^'

Mellis despumati q. s.

Ut fiat electuarium ; vel,

310. R. Sulphuris 5iv.

Supertartratis potassae 31.

Syrupi zingiber, q. s.

Ut fiat electuarium, sit pro dosi coclilearium parvulum,
vel medium, nocte maneque.

This is perhaps the laxative which operates the most
gently and quickly, moving without irritating the
bowels.

Many prefer in dangerous costiveness, and incipient
colic, the oleum ricini.

311. R. Olei ricini

' Tincturae sennse

Fiat haustus aperiens, repetendus si opus erit, trium lio-
rarum intervallo.

. OF LAXATIVi; TINCTURES.

319

The tinctures of aloes, and of rhubarb, and liellebore,
we prescribe with the same intentions, an ounce for a
drauglit, in the morning, or at going to bed ; diluted as
occasion may require, with an equal proportion of pep-
permint, or of penny-royal water. But these I esteem
useftil rather as emmenagogues, or stomachics, and have
ranked them as such.

, ' Enemata.

Clysters are the best laxatives, the most unoffending,
and least debilitating, and by far the surest in their ope-
ration, and are preferable in all cases of fever, extreme
debility of any kind, and in those who have been long
bed-ridden. But glysters, conjoined with powerful ca-
thartics, the former exciting the rectum, while the latter
stimulate the bowels, are among the most effectual
means of removing dangerous obstructions. Nor is it
indeed safe to excite the intestines in ileus and hernia,
without being at pains to procure a corresponding action
in the lower part of the intestinal canal.

312. R. IVIuriatis sodte drachmas tres, vel cochlea-

rium magnum.

Solve in decoctura avense ; vel,

' Infusi lini usitatissimi ; vel,

' Infusi anthemidis nobilis libram ; adde,

Olei Europaei ^i* vel cochlearia duo.

>iit pro enema aperiens.

313. R. Infusi cassia3 senna? diluti libram.

Sulpha tis magnesiae, vel sodae unciam,
Saponis sebacaei semiunciam.

- ' Olei Europaei ^i.

320

PmiGING AND I.AXATIVE CLYSTERS.

Clyster catharticus, vespere injiciendus, ad promoven-
dam operationem pulveris, vel pilularum coloquinti-
dis, gambogiaE?, &c.

314. R. Infusi cassias sennae Ibi.

Sulphatis sodae ^

Olei ricini ^iss.

•»

Fiat enema.

315. R. Aloes socotorinze 9ii.

Vitelli ovis q. s. ad solvendum.

Decocti avense sativae, (gruel) ; vel,

Lactis vaccini Ibi.

Fiat enema purgans, vespere injiciendum.

316. R. Extracti colocyntliidis

Aquae ferventis Ibi.

Macera per horam, et cola ; sit pro enemate.

317. R- IVIuriatis sodae cochlearia duo.

Aceti uncias duas.

Infusi anthemidis nobilis ^viii.

Fiat enema.

318. R. Resinae pini laricis semiunciam in vitelloovi

solutae.

Decocti hordei, (barley water), Ibi.

Olei Europaei, vel lini usitatissimi, Jiss.

Fiat enema terebinthinatum, sed quando de colica peri-
culoso, de enteritide, vel hernia incarcerata, agendum
est, addantur tincturae opii ^ttae sexaginta ad cen-
tum.

319. R. Infusi nicotianae tabaci 5i* *. infunde,

Aquae ferventis libra, per quadrantem horae.

OF ANTHELMINTICS.

321

Of Anthelmintics.

l^i?, Of such medicines as poison and destroy worms.
2f/, Of such as loosen and discharge them.

320. R. Pulveris stanni unciam, divide in doses duo-

decim.

Sumatur imam quotidie mane in quovis ctasso vehiculc^
sacchari residue, confectione am*antii, &;c.

321. R. Pulveris stanni ^iii.

Confectionis rosae gallicae 5iu*

Syrupi q. s. ut fiat electuarium.

Sumatur cochlearium magnum, tempore matutino-

322. R. Pulveris stanni ^i.

Electuarii cassiae sennse 3iii.

Syrupi zingiber, q. s.

Ut fiat electuarium molle, cujus sumantur cochlearia duo
minima quotidie.

323. R. Seminis artemisite santonici ^ss. ; divide in

doses decern.

Sumatur una quotidie mane, vel mane et vespere.

324. R. Pulveris stanni.

■ ' • seminis artemisiae santonici aa gr.

XV.

Fiat pulvis quotidie sumendus, in quovis crasso vehiculo.

325. R. Seminis artemisiae santonici ^i.

Sulphatis ferri gr. ii.

Fiat pulvis, quotidie mane sumendus.

TOL. III. X

322

OF ANTHELMINTIC PURGES.

326. Be. Gambogiffi grana octo.

Subinuriatis hydrargyri grana quinque.

Fiat bolus, mane sumendus.

327. Be. Dolichi prurientis legum. pubis ^ss.

Syrupi cujusvis q. s.

Ut fiat electuarium ; dentur pro dosi cochlearia tria quo-
tidie mane, usque ad tertiam vicem.

328. Be. Pulveris stanni ^i.

radicis polipodii filicis niaris 3vi.

convolvuli jalapse.

Sulphatis sodse aa ^i-
INIellis despumati q. s.

Ut fiat electuarium : siimat ajger cochlearium parvulum, ft
secunda quaque bora, per dies tres ; postea, purgatm f

alvus usu radicis jalapse, scammonias, vel gambogia?. ' i

f . j

329. Be. Pulveris convolvuli jalapas.

sulphatis sodae aa 9ii.

convolvuli scammoniae 9i. ,

Gambogiae gr. x. . ^

Fiat cum melle electuarium : sumat aeger cochlearium i
parvum quater in die, et si opus sit, enema catharti-
cum ; contra teniam, vel cucurbitinam.

330. Be. Radicis polipodii contriti filicis maris drach-

mas duas.

Sumatur primo diluculo in cyatho aquae mentliae pipe- J
ritae ; elapsis duabus horis, sumatur bolus catliarticus
submuriatis hydrargj'ri, granis quinque, gambogijc
semiscrupulo.

331. Be. Corticis geoffreae inermis pulverizati Ji.

Aquae libras duas ; coque leni igne, ad U-
bram, et cola.

Sint pro dosi, cochlearia quatuor.

OF anthelmintic GLYSTERS.

323

Sea salt is sometimes given as a poison for worms, co-
loured, that the vulgar, of whatever rank they be, may
not contemn so trivial a remedy.

«

332. R. Muriatis sodas ^ii.

Cocci cacti 9ii.

Fiat pulvis, cujus detur drachma, dimidium tempore
matutino.

The ascarides nestling lower, viz. in the rectum, are
to be destroyed only by oil, or poisons, as camphor,
bitters, &c.

333. R. Camphoras

Olei Europeae

Enema, hora somni injiciendum, tertia quaque nocte.

This glyster, or one of oil unimpregnated, appeases
the irritation and itching proceeding from the biting of
the ascarides, suffocates them, and they pass in the
morning-stool dead.

•

334. R. Olei Emopeae 3!.

Aquas calcis ^iii. /

Fiat injectio contra ascarides.

335. R. Aquae calcis Ibi.

Fiat enema, omni nocte injiciendum.

336. R. Foliarum rutae graveolentis.

juniperi sablnae.

artemisiae absinthii aa 5hi- co*

que ex

Aquae purae libra, ad uUcias decern.

XJt fiat enema.

324

OI> DIAPHORETICS AKD SHDOllIFICS.

337. Be. Aloes socotorinae ^ii. solve in
Decocti avenge sativse 5X.

Pro enemate anthelmintico.

OF DIAPHORETICS AND SUDORIFICS.

These two orders of medicines differ, as I have ex-
plained, not merely in degree, but in quality. It is not
that diaphoretics merely produce a gently perspirable
state of the skin, while sudorifics cause profuse sweat-
ing ; but, that the former are medicines of a refrigerant
nature, viz. antimony, acetas ammonias, citras potassae,
camphor, ammonia, and other medicines, which may be
given in acute fever, and in inflammatory disease ; while
the latter are hot, stimulant drugs, as opium, guaiacum,
sassafras, aconite, fit chiefly for chronic diseases, accom-
panied with severe pain. The former class, viz. the
saline sudorifics, are those which we have almost wholly .
, anticipated, under the head of Febrifuge Draughts,
gentle diaphoretics, useful in suspending fever, keeping
the head clear, and temporising through the early stages
of the disease, till that period arrive in which wine and
cordials may be safely given ; while the latter, we re-
served for this chapter : and as they are chiefly prescrib-
ed in severe rheumatism, in sypliilis, gout, and painful
nervous diseases, it seems natin-al not to refer my read-
er Avholly to the other sections of this woi*k, but to
prescribe along with these sudorifics, such anodynes and
external applications as are found efficacious, together
with them, in alleviating pain, forming as it were one
process of cure. The same sudorifics are also prescribed
us alterative, aided by the outward application of seda-
tives, in cutaneous and ulcerous diseases.

I

DIAPHORETIC MIXTURES AND DRAUGHTS. 325

The saline diaphoretics, then, combined with small
proportions of opium, camphor, or tartrate of antimony,
or with ipecacuanha, are those best adapted to continued
fever, and exanthematous diseases.

338. Be. Aquas acetatis ammoniee.

cinnamomi aa ^iv.

Syrupi ^ss.

(Etheris sulphurici cum alcoholi 3SS.
Tincturaj opii gtt. xl.

Fiat mistura diaphoretica, cujus sumatur cyathum vino- ‘
sum ter in die.

.339. Be. Subcarbonatis ammoniee

Acidi citri medici ^iss. ; vel q. s.

Aquse lauri cinnamomi ^iv.

Mistur. camphoratee 5iii.

Syrupi citri medici ^i.

• Spiritus oetheris nitrosi 3SS.

Sumantur ter quaterve in die tria cochlearia, vel cyathus.

340. Be. Aquae acetatis ammoniae.

lauri cinnamomi aa 3iii,

Vini antimonialis 5iiss.

Tincturae opii gtt. xl.

Syrupi simplicis Ji.

Sumantur cochlearia tria quater in die.

341. Be. Aquae acetatis ammoniae.

lauri cinnamomi aa ^i.

Vini antimonialis
Tincturae opii gtt. xxx.

Haustus diaphoreticus hora somni sumendus, superbir
bens seri vinosi cyathum amplum.

326 DIAPHORETIC ROLUSES AND POWDERS.

342. R. Pulveris antimonialis gr. iv.

ConservaB rosae q. s.

Ut fiat bolus, tertia quaque bora sumendus.

343. R. Nitratis potassse.

Sacchari puriss. aa gr. xii. ^

Oxydi antimonii gr. vi. , ;

Opii gr. ss. m.

Fiat piilvis, ter in die sumendus.

These solutions, or powders, convey diaphoretic doses
suitable to the middle stage of fevers, or febrile disorders,
as catarrhs and colds, slight rheumatism, cynanche scar-
latina, &c. But to procure a profuse and entire perspi-
ration ! to anticipate the cold stage of an intermittent
fever, to cure rheumatism, or alleviate the pains of
nodes, or venereal diseases ! requires a different process.

344. R. Pulveris ipecacuanhse cum opio ^i.

Fiat bolus, noctu poivigendus.

This is a fonn of sudorific which hardly admits of be-
ing followed by a warm draught ; for if much fluid is
dmnk after a dose of Dover’s powder, it is apt to cause
great siclcness : Such a dose is peculiarly adapted to pre-
vent the approaching paroxysm of intermittent, or for
rheumatism, which requires stimulant and acrid medi-
cines, but by no means for cutaneous diseases : Far from
inducing a slight diaphoresis, and easy state of the skin,
it is in particular habits followed by intolerable itching,
even to pain, and that accompanied with deadly sick-
ness. Antimony and calomel, with a little opium, are
the best diaphoretics in cutaneous diseases.

DIAPHORETICS FOR CUTANEOUS DISEASES. 327

345. R. Aquas acetatis ammonise

Tincturee opii.

Vini antimonialis aa gtt. xxx.

Sympi zingiber. 5^-
Haustus diaphoreticus.

346. R. Antimonii tartarizati gr. vi.

Opii gr. ix.

Confectionis ros£E 5SS.

Contunde simul, et dmde in pilulas, No. 20.; surnatur
pilula hora somni.

347. R. Opii gr. i.

Oxydi antimonii gr. iv.

Confectionis rosas gr. iv.»

Fiat pilula, quarta quaque hora sumenda, cum haustif
salino.

348. R, Opii granum.

Submuriatis hydrargyri gr. ii.

Oxydi antimonii gr. vi.

Sacchari.

- Pulveris aromatici aa gi*. x.

Fiat pulvis, mane et vespere sumendus.

349. R. Tartritis antimonii grana octo.

Submuriatis hydrargyri.

Camphorse in pulverem ope alcoholis paux*
illi reductse aa semidrachmam.

Opii grana quindecim.

Fiat massa ope mucilaginis, et divide in pilulas viginti-
quinque, quarum sumat aeger duas bis in die, in
rheumatismo, et in doloribus syphiliticis.

828

DIAPHORETIC POWDERS AND PILLS»

350. R. Pulveris ipecacuanhae et opii gr. viii.

Sacchari rubri gr. x.

Fiat pulvis, sexta quaque hora sumendus in pauxillo mel-
lis, superbibendo haustum communem salinum.

351. R. Pulveris fol. exsiccatorum aconiti gr. xii.

Aloes socotorinas gr. xv.

Oxydi antimonii ^ss.

Extract! glycyrrhizge glabrae 9ii.

Fiat massa, dividenda in pilulas duodecim : sumatur
una sexta quaque hora.

352. R. Guaiaci 5ss. *

Subcarbonatis ammonise gr. v.

Conterito ut fiat pulvis, in melle noctu sumendus.

353. R. Guaiaci drachmam.

Oxydi antimonii granum.

Supertartratis potassae 5ii- ’»* misce,
tit fiat pulvis ; divide in partes iequales quatuor. Suma-
tiir pars una mane, meridie, et vespere : habeat aeger
hora somni haustum anodynum, cum cyatho seri vi-
nos! tepido.

354. R. Guaiaci 9i.

Tartratis antimonii.

Opii aa gr. i.

Syrupi q. s.

Ut fiat bolus, bis in die sumendus.

355. R. Guaiaci grana decern.

Pulveris ipecacuanhae cum opio grana quin-
que.

Confect, rosae q. s.
tJt fiat bolus, ter in die sumendus.

DIUEETICS.

329

356. R. Guaiaci ^ss.

Gummi mimosae niloticae.

Sacchari puri aa 5i-
Subcarbonatis ammoniae gr. x.

Tincturae opii gtt. xxx.

Haustus, bora somni sumendus.

In sciatica, and severe lumbago *, in the cruel pains of
chronic rheumatism, with swollen and contorted joints ;
in the dead and heavy pains of sypliilis, throbbing when
the patient gets warm in bed, and depriving liim of half
his sleep, more acrid diuretics are required, combined
with powerful narcotics, and aided by stimulant embro-
cations.

357. R. Olei terebinthin.

Spiritus oetheris nitrosi p. ae.

Sumat aeger cochlearium minimum ter in die, in quovis
vehiculo idoneo.

258. B:. Olei terebinthini guttas triginta.

Tincturas opii guttas quindecim.

Spirit, oetheris nitrici drachmam.

Ovis unius vitellum.

Aquas lauri cinnamomi ^iss.

Misce pro haustu, ter in die sumendo.

359. R. Guaiaci.

Gummi mimos. niloticae pidverizatae.
Sacchari aa ^ss.

Olei terebinthini 3i* ; tere simul et adde.
Aquae pulegi ^viii.

Syrupi zingiberis Ji.

Fiat mistiira, cujus sumat aeger cocldearia duo ter in die,
in cyatho decocti hordei.

(

DIURETICS, NARCOTICS, AND STIMULANTS.

360. B:. Balsami pini laricis 5ss. invitello ovis soluto.

Aquae menth. piperitae,

Mucilaginis gummae niloticae aa ^vii
Syrupi zingiberis 5b-
Fiat haustus, ter in die sumendus.

361. R. Oxydi antimonii gr. iv.

Submuriatis hydrargyri gr. ii.

Extracti conii maculati gr. iv.

Fiat pilula, ter in die sumenda.

362. R. Extracti hyoscyami nigri gr. v.

Fiat pilula, quarta quaque bora sumenda.

363. R. Extracti aconiti napelli gr. i.

Supertartratis potassas 5b
Sacchari 5ss.

Fiat pulvis, ter in die sumendus.

364. R. Pulveris seminis sinapis albi 5SS.

Acetis ^i.

Fiat embrocatio.

365. R. Olei terebinthin,

Europea? aa 51.

Aquae ammonise.

Tincturae opii aa 5SS.

Fiat linimentum, quo saspe illinantur artus dolentes ;
vel, illinantur cum unguento hydrargyri camphorati.

As an alterative in eruptive, or a diaphoretic in rheu-
matic or syphilitic diseases, the decoction of sassafras,
guaiacum, and sarsaparilla, or of all of them conjointly, is
much used, and is especially useful when joined with a
mercurial course.

DIAPHORETIC DECOCTIONS.

331

366. R. Scobis ligni guaiaci officinalis ^\.

Radicis sassafras.

sarsaparillfB aa ^ss.

Aqu£B ferventis libras tres.

Decoque ad bilibram, et sub finem coctionis adde, radicis
glycyrrhizas glabrae dein cola. Sumatur partitis
vicibus, in die.

367. R. Scobis ligni guaiaci officinalis ^iss.

Radicis arctii lapae (bardana.)

Stipitum solani dulcamara?.

Uvae passae minoris aa 5SS. cola.

Coque ex aquae libras quatuor, ad tres ; sumatur bilibra
in die, partitis vicibus.

368. R. Pulveris seminum sinapis nigra? unciam; te-

rendo.

Affunde lactis vaccinae recentis libram;
adde,

Vini rhenani q. s.

Ut fiat coquendo coagulum, et dein cola; habeat aeger
semilibram. . ,

(

OF DIURETICS.

Supertartrate of potass, cream of tai'tar, one of the^
most familiar medicines, and thence the least regarded,
is yet the most powerful of diuretics, when long con-
tinued, duly supported, and combined with others:
and with this advantage it has, that while it is very a-
vailing, it is pleasing to the taste, useful in promoting
the secretion from the bowels, harmless, and equally
proper in the most simple case of gonon’hoea, or nephri-

332

OF SALINE DIURETICS.

tis, and in the most desperate state of dropsy, with dis-
eased liver.

369. R. Nitratis potassae 5ii-

Supertartratis potassae.

Pulveris gummi mimosas niloticas aa ^ss,
Misce, fiat pulvis in partes duodecim aequales dividendus :
sumatur pulvis quater in die, in aqua.

370. B:. Nitratis potassae 5ii> solve in libris duabus.

Emulsionis camphoratse.

Sumatur cyathus ter quaterve in die.

271. R. Carbonatis potassae ^iii-

Aceti q. s. ad saturationem.

Aquae lauri cinnamomi.

Emulsionis arabicae aa ^viii-
Sumatur ad libitum.

372. R. Acetitis potassae ^ii-

Aquae lauri cinnamomi 5viii.

Tincturae lavendulae spicae 5ii-
Spirit, cetheris nitros. ^i.

Sumantur cochlearia duo magna quater in die.

373. R. Supertartratis potassae Ji.

Sacchari rubri ^ss.

Divide in chartulas sex : Sumat chartulam in cyatho
aquae solutam, tertia quaque hora.

374. R. Supertartratis potassae 3iss.

Pulveris convolvuli jalapae 5iii*

Divide in doses decern ; adhibeatur una tertia quaque
hora, donee adsit vel catharsis vel uripae profluvium.

1

OF SALINE DIURETICS.

333

375. R. Supertartratis potassae ^ss. ; solve in

Aquaj libram.

Sumatur mane partitis vicibus.

376. R. Supertartratis potassae

Gambogise gr. xii.

Sacchari anizati 5iu- '

Tere simul, et divide in chartulas sex : Adhibeatiir una
quater in die, superbibens serf lactis, vel emulsionis
nitrosae cyathiim.

377. R. Spiritus oetheris nitrici Ji.

Syrupi aurantii Jii.

Tincturse lavendulae spicae ^ss.

Sumatur cochlearium magnum in aqua, vel infusione
theae, &c.

378. R. Carbonatis sodae exsiccatae 5i«

Saponis duri ^iv.

Syrupi zingiber, q. s.

Ut fiat massa, dividenda in pilulas, (No. 30.) Sumantur
tres, ter in die.

379. R. Aquae super-carbonatis sodae vel potassae Ibii.
In die sumendus, variis -haustibus.

380. R. Aquae kali (Ph. Lond.) 3SS.

Tincturae opii 5i- id.

Adhibeatur semidrachma vel guttae triginta ter in die,
in cyatho jusculi bovini vel aquae pullinae, et augeatiir
dosis gradatim in calculo vesicae.

«

381. R. Pulveris digitalis purpurese gr. ii.

Siibmuriatis hydrargyri gr. i.

Pilulae scillae gr. vi.

Fiat bolus, ter in die sumendus.

OF VEGETABLE DIURETICS. '

S34>

382. B:. TincturjB digitalis purpureas

Spirit, oetheris nitrosi ^i-
Aquse lauri cinnamomi ^vi.

Syrupi zingiber, ^ss.

Fiat mistura, cujus sumantur cochlearia duo magna,
quater in die. i

383. R. Pulveris fol. digitalis purpureae

Aquas bullientis Ibss.

Post boras duas cola, et adde,

Spiritus oetheris nitrosi ^i.
xVdhibeantur cochlearia duo magna, ter in die.

384. R. Pulveris digitalis purpureas gr. iss.

Supertartratis potassae ^i.

Sacchari gr. x. ; tere simul. »

Fiat pulvis, mane et vespere sumendus, vel ter in die.

385. R. Pulv. scillae maritimae exsiccatas gr. iii.

Opii gr. ss.

Supertartratis potassae.

Sacchari.

Pulveris lauri cinnamomi a5 gr. x.

Misce ut fiat pulvis, ter in die adhibendus.

386. R. Pulveris scillae maritimae exsiccatae gr. xii.

Submuriatis hydrargyri gr. vi.

Saponis 9i.

Fiat massa, et divide in pilulas sex ; sumantur duo, ter
in die.

387. R» Pulveris sciUas maritimae exsiccatae gr. ii.

Zingiber, gr. x.

Olei communis juniperi gr. v.

Conserv. aurantii q. s.

Ut fiat bolus, ter in die sumendus.

- SQUILLS COMBINED WITH CALOMEL, &C. 335

388. Be. Pulveris scillas maritimse exsiccatae gr. viii.

- . . — corticis lauri cinnamomi 3i-

Submuriatis hydrargyri gr. vi.

Tere simul diligenter, et divide in pulveres sex, quarum
sumatur unus ter in die.

389. R. Pulveris scillae maritimae exsiccatae 9i.

Nitratis potassae 3ii-
Supertartratis potassae.

Sacchari aa ^ss.

Pulveris zingiber. 9ii.

Divide in pulveres duodecim, et adhibeatur unus ter qua-
terve in die, superbibenti cyathum seri lactis acetosi.

390. R. Pulveris scillae maritimae exsiccatae 9i.

Pulveris convolvuli jalapae 5iss.
Supertartratis potassae ^ss.

Fiat pulvis in doses duodecim dividendus ; sumatur unus
ter in die.

391. R. Pulveris scillae maritimae exsiccatae gr. iii.

Nitratis potassae.

Pulveris gum. mimosae niloticae aa 9i.
Sumatur mane quotidie.

392. R. Haust. acidum carbonicum evolvens 511.

Acetitis scillae maritimae 3ii.

Fiat liaustus, bis vel ter in die sumendus. ,

393. R. Oxymellis scillae maritimae ^ss.

Aquae cinnamomi ^iv.

Sympi citri medici ^i.

Spirit, cetheris nitrosi 5i.

Fiat mistura diuretica, cujus sumantur cocblearia duo

336 OF VEGETABLE AND ANIMAL DIURETICS.

secunda quaque bora ; adhibeantur simul emulsionis
nitrici libras duse quotidie, additione cochlearii magiii
tincturse scillse in singulo cyatho emulsionis.

394. R. Tincturee scillae maritimas ^iii.

Carbonatis potassae 9ii.

Aquas lauri cinnamomi 3V1.

Syrupi zingiber. •

Spiritus cinnamomi aa 51-

Fiat mistura, sumantur cochlearia duo magna, quater in
die, vel saepius.

395. R. Aceti colchici antimonii ^ss.

Syrupi aurantii 5>-
Spiritus oetheris nitrici ^ii.

Sumatur cochleare medium, tertia quaque bora, in quo-
vis vehiculo idoneo.

396. R. Extracti elaterii gr. iv.

Saccbari puriss. 31 - tere simid diligenter, dein
adde,

Supertartratis potassae 3!.

Fiat pulvis, in chartulas dviodecim dividendus, adhibea-
tur una ter quaterve in die.

397. R. OxymellLs colchici.

Syrupi aurantii aa

Sumat geger cocblearium parvum quater in die in cyatho
aquEe, seri lactis, vel emulsionis nitrici.

398. R. Tincturae lyttse gtt. xxx.

Spiritus oetheris nitrici 31-
]\Iistur<e camphoratse 3xii-
Sympi zingiber. 3ii-
Fiat haustus, ter in die sumendus.

OF VEGETABLE AND ANIMAL DIURETIC 33T

399. R. Tincturas lyttse.

digitalis purpureas aa 5SS.

Syrupi zingiber. , ^

Spiritus oetheris nitrici aa |i. m,

Sumantur cochlearia parva duo in aqua.

400. R. Olei terebinthinae gtt. xxx.

— oleas Europe®

Sacchari rubri 5b.

Vitelli ovis q. s. terantur simul, dein adde,
IMucbaginis gum. mim. nilotic®.

Syrupi aurantii aa 5bi.

Aqu® menth. piperit® Jb
Fiat haustus, ter in die adhibendus.

401. R. Olei terebinthin® 5b-

ole® Europe® ^ii.

Fiat embrocatio, quo illinatur abdomen mane et ves-
pere.

Such medicines ®*e more useful in gleets, and fluor
albus, than in diseases of the kidney, or in Avant of se-
cretion ; so are the following.

402. R. Olei terebinthin®

Pulveris glycyrrhiz® q. s.

Ut fiant pilul® triginta : sumantur tres ter in die, vel
quater.

403. R. Pulveris lytt® granum.

Camphor® pauxillo alcohobs solut®, grana
quinque.

Conserv® ros® ^i.

Fiat bolus, bis in die sumendus. ' ' ' , j

VOL. III.

y

338 OF VEGETABLE AND ANIMAL DIURETICS.

404. R. Tincturse hellebori nigri ^i.

lyttae ^ss.

Sumatur cochleare parvnm, cum pncia aquas cujuslibet
aromaticae.

405. R. Camphorae 5!.

Sacchari puriss.

Vitelli ovis pauxillum ; tere simul <liligen-
/ ter, et adde,

Mucilag. g. mimosas niloticas.

Tincturae lyttae aa ^ss.

. (Etheris sulphurici cum alcohol. 5iii-

Balsam copaivas
Aquae menth. piperitae ^vi.

Sumatur cochlearium magnum ter in die, gradatim
augens dosin ad duo.

406. R. Olei terebinthinae

Submuriatis hydrargyri 5s9.

Pulveris rhaei palmati q. s.

Ut fiat massa, dividenda in pilulas sexaginta : sumantur
tres, ter quaterve in die.

In suppression of urine, along with the diuretics, and
with anodyne glysters of a hundred drops of laudanum,
and anodyne embrocations, an antispasmodic and ano»
dyne bolus should be given.

407. R. Camphorae gr. viii.

Opii gr. iss.

Submuriatis hydrargyri gr. x. vel xii.
Alcoholis pauxillum.

Conserv. rosae q. s.

Ut fiat bolus.

OF EXPECTORANTS, DEMULCENTS, kc.

339

408. R. Pulvcris arbut. uvse.ursi 5ss-
Opii gr. ss.

Olei terebintliinaa q. s.

Ut fiat bolus, ter quaterve die siimendiis.

OF EXPECTORANTS, DEMULCENTS, AND PECTORAL
ANODYNES.

My reader will perceive by this complicated, and not
very correct title, that it is my intention here, as in
other subdivisions of my subject, to represent a whole
department of practice ; to prescribe not merely those
more powerful and stimulating drugs by which we ima-
gine that expectoration, or in other terms, the secretions
of the trachea, may be promoted, but also the demul-
cents, the oily and mucilaginous draughts, and tlie
slighter anodynes, by which the severities of a bad cold,
or rheum, may be alleviated, and the antispasmodics, by
which the severe paroxysms of hooping-cough, may be
rendered less dangerous. In arranging these, I shall ad-
vance from the more familiar, to the most important and
the most doubtful remedies. The morning dose of ipe-
cacuan, prescribed by Aiken side in asthma, has abeady
been mentioned ; and the use of emetics in the hooping-
cough of children, and in the catarrh of adults. After
an emetic, with which we usually begin the cure of a se-
vere cold, and those cathartics which we prescribe in
all such inflammatory diseases, especially in spasmodic
cases, we give gentle opiates, camphorated emulsions,
nitrous juleps, and oily draughts ; and it may be observed
once for all, that in recent, slight colds, we give purges,
nitrous draughts, and oily linctus ; in severe colds with
incessant coughing, opiate and paregoric draughts ; in
-true peripneumony, nitre, camphor, and digitalis ; buj

Y 2

340

PECTORAL MIXTURES.

opium we give rarely, and with a sparing hand. In
phthisis we give digitalis : in chronic catarrh, opium, earn-
phor, ammoniacum, myrrh7"*and squiUs : in asthma,
ether : in hooping-cough, cicuta.

409. Br. Pidveris ipecacuanhas compos, Qi. ^

Syrupi aurantii q. s.

Utfiat massa ; divide in pilulas quinque : sumantur qua*
tuor in die.

410. Be. MueiJaginis gummi mimos® niloticas.

Aqu£B lauri cinnamomi aa Jiii.

]Syrupi tolutani ^i.

Tincturas opii ammoniatie 5iiss.

Fiat mistura, cujus sumantur cochlearia duo magna so
cunda quaque hora, vel saepius.

411. Be. Cetacasi.

CamphoraB 9ii.

Vitelli ovis q. s, ad solutionem,

AquEB menthfe piperitas ^v.

Syrupi ^i.

Tincturse tolutanas 355,

Tincturas opii

Fiat mistura, cujus sumat aeger cochlearia duo magna,
saepe in die,

412. Be. Nitratis potass® ^i. solve in

Aquge lauri cinnamomi 3iv.

Mucilaginis g. mimos® nilotic®.

Syrupi tolutani aa 5i.

Tinctur® opii
Tartritis antimonii gr. iss.

Sumatur cyathus parvus ter in die, vel quater, s®pius
urgente tusse.

PECTORAL PILLS AND EMULSIONS. S4l

413. R. Oxymellis scillse. *

Mucilaginis gum. mimosse niloticas.

Syrupi zingiberis aa

Fiat linctus, saspe in die sumendus, cochleariis parvulis.

414. R. Nitratis potassas 3i* solve in

Aquae hordei Jviii.

Oxymellis scillas ^i.

Sumantur cochlearia tria ampla, saepe in die<

415. R. Pulveris scillae exsiccatae ^i.

Gummi resinae ammoniaci.

Extracti glycyrrhizae glabrae aa ^i-
Conii maculati gr. x.

Subige in massam diligenter, et divide in pilulas viginti-
quatuor ; sumat aeger pilulas duas mane,' meridie, et
vespere.

416. R. Aquae ammoniae 3ii*

Olei olese Europeae Jiss.

Sacchari puriss. 3iii*

Olei menth. piperitae gr. viii.

Aquae fontis.

lauri cinnamomi.

Mucilaginis gum. mimosae niloticae aa 5U.
Tincturae opii gtt. xl.

Misce, ut fiat emulsio ; sumantur cochlearia duo, secun-
da quaque bora.

417. R. Olei oleae Europeae ^i.

Aquae ammoniae 3i-
Mucilag. g. mimosae niloticae.

Aquae menth. piperitae aa ^iii-
' Syrupi tolutani Ji. m.

Emulsio, cujus sumatur cochlearium saepe, ufgente tusse.

543

PECTailAL DRAUGHTS,

418. R. Mellis,

Mucdl. gum. mimos. nilot.

Olei olese Europeas aa 5U.

Tincturae opii 5i-

Misce diligenter, ut fiat linctus, cochlearium saepe in die
sumeiidum.

419. R. Gummi mimos. nilot. scrupulum.

Sacchari drachmam.

Camphoree pulveratse, aliquot alcoholis gut-
tas.

Simul tritis, adde,

Aquse fervidae imciam.

Tinct. opii guttas triginta.

Ut fiat haustus, cubituro adhibendus.

420. R. Gummi mimosae niloticae pulverisata?.

Sacchari puriss. aa 3ii*

Olei oleae Europeae Jss. misce, et adde
Aquae ferventis
(Etheris sulphurfci 51
Fiat haustus, hora decubitus sumendus.

421. R. Gummi resinae ammoniac. gr. X. diffunde in

Aquae ferventis adde
Tincturae opii ammoniatas
Vini antimonialis 5ss.

Fiat haustus, ter in die sumendus.

422. R. Gummi resinae ammoniac, drachmas tres.

Subcarbonatis- potassae ,^i.

Tincturae opii camphoratae 5u-
Aquae menth. piperitae ^viii.

OxymeUis scillae ^i.

Fiat mistura, cujus sumantur cochlearia duo'magna, tef
in die vel saepius.

PECTORAL PILLS AND DRAUGHTS. 343

423. R. Gummi resinse ammoniac. • ,

myrrhae aa 5i«

p Aquaa ferventis ^vi. ; tere simul et adde,

Misturse camphorae gii.

Spiritus oetheris nitros. ^ss.

Tincturae digitalis purpureae
Sumantur cochlearia duo vel tres, tertia quaque hora

424. R. Gummi ammoniaci

Camphorae 9i.

Oxydi antimonii gr. vi.

Tere simul diligenter, cum pauxillo alcohblis,j ut fiat
massa, dividenda in pilulas duodecim. Sumantur pi-
dulae duae, tertia quaque hora.

425. R. Radicis scillae maritimae siccatae.- •

Gummi resinae ammoniaci.

Pulveris zingiberis aa 5l
Olei terebinthrnas q. s.

Subige in massam, et divide in pilulas quadraginta ; sii-
mantur tres ad quinque ter in die.

426; R. Gummi resinae myrrhae r ■

Pulveris aromaticae 5i*

Sacchari rubri ^ss.

Opii gr; viii.

Tere simul diligenter, et divide in partes quatuordecim
aequales ; sumatur pars una ter in die. ;

This is a medicine universally useful in chronic and
mucous cough, or winter colds, especially in the relaxed,
feeble, or aged ; but it is in the same proportion dan-
gerous to those affected with true phthisis pulmonis, or
with pneumonia.

, • For those prescriptions of digitalis, ether, and cicuta.

344* •' OF lEMM«NA®OeUES.

by which we subdue vascular action, or spasm in boOp-
ing-cough, and asthma, see the sections on sedatives and
antispasmodics. Such ^ draught as follows, is given
with much benefit in hooping-cough.

427. R. Vini antimonialis guttas decem.
i Extract! conii maculati jgr. ii.

Aquffi pulegi 5xii.

Syrupi papaveris somniferi 5^-
Haustus, ter in die sumendus.

The combination of digitalis or of aconite, in the
same form with the antimony, is very potent in sub-
duing spasm, or vascular action, either in dangerous
pneumonia, or pertussis; or in severe rheumatism, or
syphilitic pains of the bones.

428. R. Vini antimonialis '

Extract! hyoscyami ni^ gr. iss.

' ' Tincture opii gr. xx. ,(

Aquse menthie piperitae ^xii.

Syrupi zingiberis 3iii-
Fiat haustus, hora decubitus sumendus.

Of Emmenagogues. ‘

<

Of those- medicines which promote the flow of the
menses, it would be difficult to affirm that any were spe-
, cifically emmenagogue : but whatever medicines are
prescribed with that design, may be named so. Among
those aloes, and opium, rightly managed and alter-
nated, are perhaps the most precious. If I were to
mark any leading distinction, to guide the young phy-
sician in practice, it would be into medicines, first, di-

SAVING, CARBONATE OF IRON, ALOES, &C. 345

r6ctly stimulating the uterine system ; second^ such as
operate by strengthening and exciting the wliole frame :
Among the former, I should enumerate as principal, sa-
Vine, cantharides, aloes, hydrargyrus ; among the latter,
iron, myrrh, madder. But by this I mean not to make
a very absolute distinction betwixt stimulant and
strengthening medicines ; but rather to indicate the or-
der in which I choose to make the prescriptions which
I next offer to the reader.

Sabina may be given alone or triturated (for it means
no more) with sulphate of potass, or qualified by the
addition of ginger, or Combined with iron, or with mer-
cury.

429. - R. Pulveris junipm sabinae. ' .il .

1 aromaticae. — ----

Carbonatis magnesias aa 5iss.
iDivide in partes aequales quatuordecim : Sumatur una
bis in die.

430. R. Pulvais foliorum juniperi sabinas 5ik

Carbonatis ferri
Pulveris aromaticae 3ii*

Misce, et divide in partes duodecim : sumatur una bis
in die.

431. R. Pulveris juniperi sabinae.

zingiber.

myrrhas aa gr. x.

Sulphatis potassae ^ss.

Fiat pulvis, bis in die sumendus.

432. R. Pulveris juniperi sabina?.

— ■ myrrhas aa gr. x.

Aloes socot(M*mae gr. iii.

Pulveris .aromatiqi 3^^* ^

Fiat pulvis, man^ et vespere sumendus.

LYTTA, HELLEBORE, ALOES, IRON, &C.

‘M6

433. Be. Tincturas lyttaa 5iss.

,.i. hellebori nigri 3iss.

Misce, sumatur cochleare parvum bis vel ' ter in die, in
aqua tepida.

434. Be. Tincturae aloes ^iss^ '

— lytt« 3i.

Sumantur cochlearia duo bis in die.

435. Be. Tincturae hellebori nigri 3i.

Sumat aeger coclileare parvum bis in die, in aqua te-
pida.

436. Be. Tincturae aloes ^ii.

hellebori nigri |i. \

Sumantur cochlearia tria, bis in die, cum aqua menthae.
piperitae.

437. Be. Gummi resinae myrrhae 3ui-

Pulveris zingiberis 3i*

Sulphatis ferri 9ii.

Balsamae copaibae.

Mucilag. g. m. nilot. aa 31.

Aquae pulegi 3vi.

Misce, sumantur cocldearia duo magna ter in d!ie.

438. Be. Mass® pilularum myn'h® composit®, (viz.

myrrh®, aloes, et croci anglici).

Sulphatis ferri aa 3i-
Pulveris seminis capsic® 9ii. .

MucUaginis q. s.

Ut fiat massa, dividenda in pilulas viginti quinque ;
quarum sumat aeger tres bis in die, vel s®pius.

IRON, ALOES, HYDRARGYRUS, &C.

347

439. R. Carbonatis ferri.

Gum. resin. myrrha3 aa 5SS.

Aloes socotorinas 9i.

Opii gr. vi.

Fiat massa, dividenda in pilulas quindecim : sumantur
tres, ter in die.

440. R. Massae pilulae hycirargyri 5i-

Pulveris myrrhae coniposit.

Subige in unam massam, et divide in pilulas triginta
sex; quarum sumat aeger tres quater in die; sed
semper caveat. medicus, ut vix et ne vix quidem alfi-
ciantur gingivae, et halitus oris. ^

441. R. Massae pil. myrrhse composit.

Submuriatis hydrargyri 9i.

Subige diligenter terendo, in massam, ope mucilaginis ‘
divide in pilulas viginti; quarum smnat aeger treS
bis in die.

Simul utatur pediluvio, et habeat nora decubitus haustum
anodynum, e tincturae opii guttas viginti quinque.

4^2. R. Pulveris myrrhae edmpositi (viz. myrrhae,
rutae, et sabinae, p. as.) ^ii-

Forme in massam, dividendam in pilulas Viginti qua-'
tuor, quarum sumat aeger tres, ter in die.

443. R. Pulveris myrrhae compositi 9i-

Sulphatis ferri gr. iii.

Pulveris capsici gr. x.

Fiat massa, dividenda in bolos duos.

444. R. Pulveris myrrhae compositi gr. x.

Sulphatis ferri gr. iss.

- Pulveris sem. capsici gr. iv. j' .

' Confectionis aurantii q.

348 RUBIA TINCTORUM, LYTTA, HELLERORfe, &C.

Ut fiat bolus, quater in die sumendus ; vel Sumantur
boli duo ter in die. ^

445. Be. Pulveris aloeticus cum ferro 5iu*

t)ivide in partes gequales Viginti : Sumatur una ter vet
quater in die, in quovis crasso vehiculo..

I

446. Be. Rubiae tinctorum ^ss.

Pulveris aromaticae 3ii‘

! ; t- Mucilaginis g. m. nil.

^ ; • • Syrupi zingiber, aa 5i.

Aquae menth. piperitae

Sumantur, agitata phiala, cochlearia magna tria, ter in
die.

447. Be. Radicis rubiae tinctorum 9ii.

Carbonatis ferri gr. vi.

Sacchari rubri ^i.

Fiat pulvis, ter in die sumendus.

448. Be. Tincturae lyttae 5ii-

cardamomi 5iv. , ^

Misce, sumat aeger cochleare parvum ter in die, in qiio^
vis vehiculo idoneo.

449. Be. Extracti hellebori nigii 9i.

gentianae Qii.

Fiant pilulae No. 12. quaruih sumantur duae, nocte
maneque.

Of Stimulants.

The slightest stomachic cordial, such as we give for
curing acidity, and removing spasms, or pain, is a sti-

OF STIMULANTS,

349

mulaiit ; and the highest exciting power, such as we
use in the cure of hemiplegia, or any partial paralysis, is
still but a stimulant, as simply as the former : and wme,
alcohol, or oether, are, according to the way in which
they are xised, either the most dehcate cordials, or the
most dangerous exciting powers. When medicines, the
most trivial, and those of the most powerful cfRcacy,
iu*e thus classed under one common denomination, the
trifling and the dangerous are apt to be confounded;
when the most ordinary arrangement, if arrangement it
may be called, is to name them according to alphabeti-
cal order ; when they are thus thrown down pell-mell be-
fore the young physician, in one undistinguished heap, no-
thing surely can be more perplexing, nor can more tend to
engender an irresolute, timid, vacillating practice. To
throw the dice, and arrange the most precious resources
of our art, at sixes and sevens, as the dice fall, would be
a master-piece of ingenuity, compared with this of the
alphabet ! I know well, that there are sensible men,
who are averse from any arrangement, who seem willing
to beheve, that their very intellect and senses might be
fascinated by one invidious glance of a well-ordered list.
But what fascination, what dangerous theory can be
imagined, in distinguishing stimulants as feeble or power-
ful, cordial or exciting ? fit for exhibiting in slight hys-
terical languor, or in universal palsy ? Upon my word,
I can find no offence in arranging medicines, not ac-
cording to the phantasms of a whimsical imaguiation,
but according to the suggestions of plain sense. 1 have
found it useful to form, and would fain engage my
reader in forming for himself, some sort of order corres-
ponding with what experience dictates, of the known
and acknowledged powers of medicines, or of their effi-
cacy in particular diseases.

Stimulants, I have been accustomed to think of, as

350

OF STIMULANTS.

fulfilling some of the following purposes. Stimulant
medicines are useful, rarely for the purpose of accelerating-
circulation, but chiefly for exciting the sensibility
the nervous system. No doubt they have this effect,
partly by exciting a more lively circulation, which affects
sensation, and thence alters the condition of the nerves,
but chiefly by dii-ectly exciting that sensibility of which
the nerves are the organs. Stimulants excite either
topically the nerves of the stomach, or generally the
nerves through those of the whole system ; or, finally, by
a moderate and sustained excitement, they invigorate
both the nervous system and the vascular actions. •

Stimulants I have been accustomed to think of as
fillfilling one or other of the following purposes : Firsts
By directly and immediately exciting the nerves of the
stomach, stimulants prove cordial, and are useful in
pains of the stomach, spasms, indigestion, and all other
forms of dyspepsia ; in hypochondriacism ; in hysterical
languor, or in hysterical fits and convulsions ; in faint-
ings, coldness of extremities, and asphyxia, or suspension
of animation ; in the deadly paleness, sickness, and faint-
ing, with which the palsy of old age often begins, a
palsy not urged on by accelerated circulation, or organic
disease, but arising rather from want of power in the
cii’culating system.

The medicines suited to those occasions, are the
smaller doses of wine as a cordial ; of oether, alcohol, and
alcoholized aether, cordial doses, viz. small and frequent,
of opium and ammonia, the bitter tinctures, especially
those of columbo, serpentaria, aloes, gentian, and rliu-
barb, capsicum, chamomile, and bitters, and rubefacients,
appHed to the stomach, or to the head. Those arc
many of them anticipated in the febrifuge prescriptions,
for fever is just this state of nervous languor produced
Ijy accelerated circulation, and cured by cordials. But

OF STIMULANTS.

351

at present we have chiefly to present those medicines
which are appropriated to complaints of the stomach it-
self; these are either the lowest stimulants, viz. bitters,
tinctures, &c. or the most moderate of the more
powerful.

Second^ Though it is through the nerves of the sto-
mach, that all stimulants, whatever their strength or
qualities, have their effect upon the system ; yet there
are some on which we peculiarly rely, in affections of
the whole body. When hemiplegia, or when total palsy
have taken place, when the powers of the pervous sys-
tem are to be awakened, and the muscular motions re-
stored, we have recourse to rough and harsh stimulants,
in large doses ; and many of these are peculiarly acrid,
as ammonia, lytta, terebinthina, arnica, sinapis, zingiber,
capsicum, pulvis aromaticus, essential oils. These are
intense and acrid stimulants.

Thirds There are stimulants whose operation is more
gradual, permanent, invigorating, and which should
more justly be denominated tonics, as bark, bitters, steel,
&c. Those several classes of stimulants all tend to one
effect, viz, the exciting and supporting the powers of
life ; while almost all the medical powers hitherto enu-
merated, tend rather to subdue than to support the ac-
tions of the living machine.

Fourth, The stimulants liitherto enumerated are all
aided by a fourth order of stimulants, viz. the same
stimulant powers externally applied, viz. ammonia,
opium, and alcohol ; lytta, terebinthina, sinapis, and ar-
moracea. To provide the young physician with a com-
petent number of prescriptions for these purposes, is the
next object.

W iNE is no longer sent from the shop of the apo-
thecary, and can hardly be written down as a medical
prescription. In hospital practice, and in fevers, it is.

352 STIMULATING DEAUGHTS AND MIXTURES.

sometimes written for by the attending physician, or by
the surgeon in cases of fever, diarrhoea, dysentery, or
gangrene.

450. R. Vini rubri uncias duodecim.

Aquae uncias sex. >

Sumatur uncia subinde, et repetatur singulis horis.

We are inclined, in faintness and in hysterical pa-
roxysms, to prescribe any medicine rather than wine ;
and in the palsy of the aged and debilitated, we require
a more immediate and powerful' excitement.

451. R. Alcoholis ammoniati 5i-

Aquae lauri cinnamomi 51.

Syrupi m.

Fiat haustus, ter in die repetendus.

452. R. Alcoholis ammoniati 5SS.

Aquae menthae piperitae.

lauri cinnamomi aa ^iv.

Syrupi zingiber. 51-

Fiat mistura, cujus adhibeantur cochlearia magna tria
saepe in die.

453. R. Alcoholis ammoniati.

Tincturae lavendulae spicae aa Jss.

aristolochiae serpentariae 3!.

Misce; sumat aeger cochlearia paiwa duo, in aqua te*
pida, ter in die.

454. R. (Etheris sulphurici. alcoholizati ^i.

Tincturae lavendulae Jss.

Sumat aeger cochleare parvum, cum saccharo, vcl in
quovis vehiculo aquoso.

STIMULATING DRAUGHTS AND MIXTURES- S53

455. R. Aquas menth® piperitse 5XV1.

Saccharr 5ii-
(Etheris sulphurici

Misce ; quarta vel sexta quaque hora, adhibeatur cya-
thus parvus in typho, in paralysi, vel in gastrodynia ;
addantur in hocce cyatho guttse decern tinctura? opii.

456. R. Syrupi zingiber.

Aquse lauri cinnamomi aa |ii.

fontis ^iv.

Olei anethi guttas vi^nti.

Tinctur® lavendul® spic® 3ii-
Fiat mistiira ; siimantur cochlearia tria ter in die.

457. R. Camphor® gr. iv. solve in

Alcoholis 5l

Aqu® lauri cinnamomi ^i.

Syrupi

Subcarbonatis ammoni® gr. x.

Fiat haustus, tertia quaque hora exhibendus, in gastro-
dynia, defectione animi, hysteria, paralysi. Vel,

458. R. Subcarbonatis ammoni® gr. x.

Camphor® gr. iv.

Conserv® ros® q. s.

Ut fiat bolus.

Though the subcarbonate of ammonia is at once a
powerful stimulant and antacid, yet its absolute quan-
tity is not such, as to neutralize any great proportion
of acid in the stomach ; we are thence in the habit of
adding the carbonate of lime.

z

VOL. III.

354

KTOJVtACHIC BITTEKS.

459. B:. Carbonatis calcis 5u-

Subcarbonatis ammonije 9i.

Mucilag. gum. mimos. nilot.

Syrupi zingiber.

Aquas menthcB piperitae aa
Tincturae opii gtt. xl.

Agitata phiala, sumatur cyathus parvus singulis horis,
donee levatur ventriculi dolor, in gastrodynia, pyrosi,
&c.

460. R. Carbonatis calcis ^i.

Pulveris amomi zingiber, gr. vi.

Sacchari 5i*

Tincturas opii gtt. x.

Fiat haustus, secunda quaque bora sumendus.

461. R. Sacchari anizati

Olei menthas pulegi gtt. vi.

Pulveris lauri cinnamomi
Aquas purse |iss.

Fiat haustus. :

462. R. Tincturae columbse 5h-

Aquae ammoniae gtt. xv.

menthae piperitae 3!.

Misce, ut fiat haustus.

463. R. Tincturae columbas.

aristolochiae serpentariae.

rhei palmati aa ^ss.

Sumantur cochlearia duo parva ter in die, in cyatho
parvo aquae tepidae.

STOMACHIC BITTERS AND CORDIALS.

355

464. R. Tincturae gentianae lute«.

— aristolochiae serpentarias aa 3ss.

rhei palmati ^iss.

Aquae menthae piperitae ^^vi.

Misce : sumat aeger cochlearia magna duo, mane et ves-
pere.

These bitter stomachic tinctures, at the same time
that they are the fittest cordials, in those enfeebled by
ague, or fever, in the giddiness that accompanies these
disorders, or remains after them, and in hysterical and
hypochondriacal disorders, are also the best regulators
of the bowels, and best promoters of digestion.

465. R. Tincturee valeriange ammon. Phar. Lond.

Spiritus lavendula? comp. 5ih
Spiritus ammonise aromatic! 5i*

Aquae lauri cinnamomi ^iv.

Fiat mistura, cujus sumatur cochlearium magnum pro '
dosi.

466. R, CEtheris sulphuric! 3i*

Tincturge opii gtt. xx,

1. castorei 3i-

Spiritus carui 3SS.

. Syrupi 3ii.

Fiat haustus, ter quaterve die sumendus.

i

467. R- Pulveris capsici 3h

cinnamomi ^i.

I ^ .

J Fiat massa, dividenda in pilulas quatuqrdecim, quarum
«umat £Bger quatuor, ter vel quater in die.

■ X 2

356

STOMACHIC BITTERS AND CORDIALS.

468. R. Carbonatis ammoniae gr. vi.

Pulveris baccae capsici indici gr. iv.
Confectionis opii Phar. Lond. 9i.

Fiat massa, dividenda in pilulas quatuor, quarum iina
singulis lioris sumenda.

To allay sickness, or to excite and support the sto-
mach, a few grains of cayenne pepper may be infused in
boiling water, or mixed with a glass of \varm ISfadeira
and water, or white-wine whey.

469. R. Sulphatis ferri gr. xv.

Pulveris capsici indici.

aromatici aa 5i-

JMagnesiaj 5ii-

Misce et divide in p. as. duodecim : sumat asger unam ter
in die, in dyspepsia, dolore ventriculi, &c.

470. R. Pulveris radicis valerians sylvestris 9i.

Subcarbonatis ammonise gr. xv.

Aquas lauri cinnamomi 3ii.

Fiat haustus, quarta quaque hora sumendus.

/

471. R. Aquas carbonatis ammonise 5k

lauri cinnamomi.

menthaa piperite.

fontis aa 3iiss.

Sympi aurantii ^i.

Sumatur uncia in gastrodynia, syncope, vertigine, Sec.

472. R. Confectionis aromaticas 5ik

Subcarbonatis ammoniae 5ss.

Pulveris cinnamomi 5k
Syrupi aurantii ^iss.

Aquas lauri cinnamomi 5^'ki.

Cyathum parvum ter in die.

ACRID STIMULANTS.

357

473. R. Pulveris radicis aristolochias serpentarise

Camphorse pauxillo alcoholis solutae gr. x.
Confect. rosEB q. s.

tit fiat bolus, tertia quaque hora sumendus.

474. R. Pulveris radicis amomi zingiber.

Seminum a. cardamomi.

Piperis longi.

Radicis acori calami aa ^ss.

Magnesise 5ii*

Tere simul diligenter in mortario ; divide in partes duo-
decim r- sumat asger partem unam ter in die, in lan-
guore ventriculi, dyspepsia, diarrhoea atonica, &c.

475. R. Pulveris aromatici.

Carbonatis calcis aa 5ii-

Pulveris ipecacuanhse cum opio 9ii.

Misce et divide in pulveres duodecim ; sumatur una
Omni quadrante hora.

We turn next to the more pungent and acrid sti-
mulants, such as are used in paralysis, or the most severe
rKeumatism. r

476. R. Pulveris lyttse gr. x.

Spiritus camphorati.

Aqbffi menthse piperitae aa 5iii.

Syrupi zingiber. Ji.

Subcarbonatis ammoniae 9ii.

Fiat mistura, cujus sumantur cochlearia duo magna, ter
in die.

477. R. Pulveris lyttae granum.

Subcarbonatis ammoniae.

Confectionis aromaticae aa 9i*

Syrupi q. s.

Ut fiat bolus, sexta quaque hora sumendus.

358

ACRID STIMULANTS.

478. R. Pulveris radicis valerianas sylvestris

Subcarbonatis ammoniae
Sympi zingiber, q. s.

Ut fiat electiiarium ; detur drachma una, vel altera unius,
vel duarum horarum intervallo.

I I -

479. R- Carbonatis ammoniae 5ss.

Aquae menthae piperitae ^vii-
Syrupi aurantii Ji.

]\Iisce, sumantur cochlearia duo magna pro re iiata.

480. R. Alcoholis diluti amari 5viii.

Olei terebinthinae 5ii-

Sumantur cochlearia duo magna in cyatho aquae lauri
cinnamomi, pimentae, vel menthae piperitae.

481. R. Olei terebinthinae

JMeUis despumati 51.

Misce ut fiat linctus. Sumatur cochleare parvum nocte
maneque, cum haustu cujusvis potus tenuioris tepc-
facti, in hemiplegia, vel rheumatismo.

482. R. Terebinthinae viteUo ovi solutae 5ss.

Spiritus lauri cinnamomi ^ss.

Aquae menth. piperitae 51.

Fiat haustus, in rheumatismo mane et vespere sumendus^

483. R. Terebinthinae venet. 5ii- Id pauxillo vitelli

ovis solutae.

IVIucilaginis gum. mimos. nilot. ^i.

Aquae menth. piperitae 5V.

Fiat mistura ; sumantur cochlearia magna duo ter in
die.

ACRID STIMULANTS.

359

484i Jki Balsami pini laricis in vitello ovi soluti 5ss.
Tincturas aromatic® 5ii*

‘ opii camphoratae 5ss.

Mucilaginis g. mimos. nil.

Aqu® menth® piperit. aa 5SS.

' r Syrupi zingiber,

Fiat haustus, vespere sumendus.

485. ' R. Olei terebinthin®

Pulveris rhei palmati q. s.

tJt fiat massa, dividenda in pilulas singulas pendentes
grana quinque ; sumantur tres, ter in die.

486. R. Olei terebinthin®

Opii.

Pulveris scill® siccat® aa gr. viii.

]\Iic® panis q. s. ut fiant pilul® triginta : sumantur treS
mane et vespere in paralysi, in blenorrhagia, vel go-
norrhoea chronica, in sciatica, urin® stillicidio et in-
continentia.

487. R. Aqu® menth® piperit® ^iv.

Syrupi scillitic® ^ii.

Tinctur® opii
— — ly tt®

'Sumatur cochleare magnum ter in die.

488. R. Seminum sinapis 5!. ■ • ...

Sumatur cochleare amplum seminum contusorum in

aqua frigida, mane et vespere/ vel cochlearia tria ter ;
in die.

489. R. Seminum sinapis albi leviter contusorum.

Conserv® aurantii aa Ji.

Sumantur cochlearia minima duo, s®pe in die.

%

360

ACRID STIMULANTS.

490. B:. Flonim arnicae montanae exsiccatas

Aquas ferventis ^xvi.

Macera per horam in vase clause, dein cola,
et iidde,

Syrupi aurantii 31.

• Sumantur coclilearia duo magna, vel tria, quater in di^,
in paralysi. »

491. R. Guaiaci 9L

Subcarbonatis ammonias gr. x.

Conservae rosae q. s.

Ut fiat bolus, ter in die sumendus. '

492. R. Balsami copaibas.

Mucilaginis g. mimos. niloticae.

Mellis despumati aa 3i. ; misce diligenter
et adde.

Aquae lami cinnamomi 5m.

Tincture opii 3SS.

Sumat aeger cochleare medium ter in die, superbibens
haustum seri lactis, vel emulsionis nitrici.

493. R. Olei terebinthinas 31.

MeUis despumati ^ss. m.

Sumatiu* pro dosi drachma, in quovis vehiculo idoneo.

494. R. Radicis cochleariae armoracias incisas unciam.

zingiber. 3i-

Pulveris aromatici 3ii*

Infunde aquae ferventis libram, stent per horam in vase
clauso, et colaturae adde,

CEtheris sulphurici alcoholizati 3^*

Syrupi aurantii gii.

Sumatur cyathus, vel uncia duse, saepe in die.

ACEID STIMULANTS.

361

495. ,R. Seminum sinapis alb. contrit.

Radicis cochleariee armoracise incisi aa 5H.
Corticis aurantii 5SS.

Aquag ferventis libras duas ; coque ad unam
libram.

Sumat aeger (rheumaticus, paralyticus, hypochondriacus)
cyathum amplum ter in die.

496. R. Seminum sinapis nigri unciam.

Terendo successive affunde.

Lactis vaccini recentis libram, tandem ad-
dite aceti vel vini rhenani q. s,

Ut fiat coquendo coagulum, coletur serum : sumatur se-
milibra bora decubitus. - ^ ' '

497- R- Amic® montanae florum exsiccatorum
Aqu« ferventis ^xvi. - f
Macera per horae dimidium in vase elauso, dein coja
et adjice,

Syrupi aurantii Ji.

Sumantur unciae duae vel tres quater in die, in paralysi,
rheumatismo, &c.

Such combinations of the more dangerous stimulants
as the following, are prescribed to very little purpose, I
believe, in impotency and want of excitement from ex-
haustion or age.

498. R. LyttaB pulverisatse gr. xviii.

Opii.

Camphor® aa gr. xxxvi.

' Conserv® rosae q. s.

Fiant pilul®, No. 36. ; capiantur 1—11, singulis nocti-
bus, hora decubitus*

362

' OF TONICS.

OF TONICS AS A CLASS OF STIMULANTS*

A tonic is merely that degree or species of stimulant,
whose operation is slow and permanent ; of these the
chief are, bark, steel, bitters, and mineral waters. My
reader is aware that I am not impressed with any extra-
vagant opinion of the efficacy of bark, in any cure but
that of intermittent. Yet its reputed excellence in sup-
porting the system in gangfene, ulcerated sore throat,
and low fever, as well as in remittent and intermittent
fever, imposes it as a duty to represent the various forms
in which it is used, viz. of mixture, draught, and decoc-
tion, pill, electuary, and extract. •

499. R. Pulveris cinchonae officinalis ^iss. ; divide in

p. ae. duodecira. ,

Sumantur tres vel quatuor in die. ’ ■ . • t-.

500. R. Pulveris cinchonae officinalis Ji.

— : rhei pahnati. - •

Carbonatis magnesias aa 9ii. - -

"Divide in doses duodecim.

501. R. Pulveris corticis cinchona) 3ss-

Sulphatis ferri gr. ii.

INIagnesias gr. vi.

Misce, fiat pulvis, mane et vespere sumendifs.

502. R. Pulveris cinchona? officmalis 51.

aromaticae 5ik

bacca? capsicas 9i.

Divide in pulveres duodecim, quarum sumatUr unus
quarta quaque hora.

OF CINCHONA AND AROMATIC^.

503. R. Pulveris cinchonae officinalis 5ss.

aromatici ^i.

Camphorae pauxillo alcoholis solutse gr. vi.
Fiat pulvis, quater in die sumendus, in cynanche ma-
ligno, sphacelo, variolo confluente, &c. '

504. R. Pulveris cindionse officinalis ^ss.

■ ■ ' ■- crotonis eleutheriae.

aristolochiae serpentariae aa gr. x. ni«

Fiat pulvis, saepius sumendus.

505. R. Pidveris cinchonae officinalis ^iv.

— ■ ■ ~ myrrhae 3ii*

aromaticae 5i-

Misce, et divide in pulveres duodecim : sumatur unus
ter in die.

' ... j

506. R. Pulveris cinchonae officinalis. ,

f . . • t t \

■ Supertartritis potassae aa ^i.

Pulveris crotonis eleutheriae 5SS.

Divide in doses No. 18. : sumatur unus tertia quaqui<
hora.

■'I

507. R. Pulveris cinchonae officinalis 3i.

Confectlonis aromaticae 5ii-

aurantii 5!.

Syrupi rosae q. s. .

Ut fiat electuarium, cujus sumatur ad magnitudinem
nucis singulis horis.

508. R. Pulveris cinchonae officinalis unciam.

Extracti glycyrrhizi giabri drachmam.
Mucilaginis g. mim. nil.

Syrupi aurantii aa 3!}.

Aquae fontis. • . .

304 OF CINCHONA AND MINERAL ACIDS.

Misturge camphoratae ^iv.

Tincturae cinchonae unciam.

Antequam bibatur mixturse, agitetur pliiala ; iii-
terdum adde,

Tincturae opii gtt. xl.

Acidi sulphuric, dibit. 5sSi
(Etheris sulphurici vel nitrici 5i-
Confectionis aurantii

0O9. R. Pulveris cinchonae officinahs 31.

Extracti glycyrrhizi glabri
Mucilaginis gum. m. nil.

Syrupi zingiber, aa ^ii.

Decocti corticis cinchonae 3vi.

Tincturae opii guttas triginta.

Fiat mistura, cujus sumat geger cochlearia tria magna,
quater in die.

510. R. Pulveris cinchonae officinalis 5^'

Extract! ejusdem Qii.

Balsami copaibge 5ss. vel q. s.

Ut fiat massa, dividerida in pilulas viginti quatuor: sir-
piantur tres quatuorve, ter in die vel sgepius.

511. R. Pulveris cinchonae officinalis 5i-

Extracti glycyrrhizi glabri 9i.

Syrupi aurantii 5ii- ; misce, dein adde.
Aquae lauri cinnamomi 5i.

Tincturae opii gtt. x.

Fiat haustus, sgepe in die sumendus.

512. R. Extracti cinchonae molliss. 31.

Syrupi aurantii 3ii.

Decocti ejusdem ^vfii* -
Acidi muriatic! qu.

Sit mistura, cujus sumatur altera quaque hora uncia.

OF CINCHONA AND AROMATICS^ ,

365

513. R. Pulveris cinckonse officinalis semiunciam.

Aqiise ferventis libram.

Decoque ad uncias decern ; exprime per linteum et cola ;
adde ad libitum, cujuslibet syrupi, quantum velis : ad-
hibeantur imciae dua?, ter in die ; interdum adduntur, ~
tincturse aristolochiaB serpentarige, vel corticis cinclionse
5i. ad 3ii. interdum acidi sulpliurici, cetheris sulphu-
tlici, acidi muriatici, &c. ad 3ii-

514. R. Acidi sulpliurici dilut. ^ss.

Tincturse cinchongB composite 5ii. ,
Misce; capiatur cochleare parsmm unum vel altenmi
bis in die, in aqua.

515. R. Corticis cinchonfE ^i.

Radicis aristolochige serpentarias 3SS.

Aqu£B ferventis libram.

JVIacera in vase clause per lioras duas, dein cola,
colaturo adde,

. Tincturse cascariUai ^ss.

cinchonas officinalis Ji.

Syrupi aurantii ^iss.

Fiat mistura, cujus adhibeatur cyathus parvus quater in
die.

516. R. Decocti cinchonse officinalis 5xii.

Tincturas ejusdem.

Syrupi aurantii aa 5ii.

Spiritus cetheris nitrici ^ss.

Fiat haustus, quarta quaque hora sumendus. Vel,

517. R. Decocti cort. cinchonas 5iss.

Tincturse compositse ejusdem 5ii»
Confectionis aromaticse 5ss.

Syrupi aurantii ^ui-
Fiat haustus, ssepe in die sumendus.

S66 OF CIIKCHONA, BITTERS, AND MINERAL ACIDS.

The muriatic acid, invaluable as it is in apthous and
putrid ulcers of the tongue, cheek, or tonsils, is far too
little used. In conjunction with the bark, it is very ef.
licacious ; it should at the same time be directly applied
to the sores with a pencil : — the acid being for this pur-
pose mixed with honey, mucilage, or syrup. ^

518. B:. Extract! cinchoiise moUis.

glycyn'hizi glabri aa 9i.

Pulveris cort. cinchonse officinalis ^ss.
Tincturee ejusdem 5ii-
Acidi muriatic! gtt. x.

Aquas menthEc piperitse Jiss.

Fiat haustus, trium horarum intervallo sumendus.

In weakness attended with diarrhoea, bark is given
with magnesia, colimibo, and laudanum.

519. B:. Corticis colombae. >

Magnesia? aa ^ii-
Extract! corticis cinchonas.

glycyrrhizi glabri aa ^ii.

ISIucilag. gum. mimos. nilot.

Syrupi aurantii.

AquEB fontis aa Jii.

Tincturee opii gtt. xxx.

Fiat mistura, cujus sumantur cochlearia duo ampla ter
in die.

520. R. Pulveris cinchonas officinalis 3iii-

Coque ex aquas puras ^xvi. ad ^viii. ; adde
sub finem coctionis,

Radicis aristolochias serpentarige 5ii- ; cola-
tura admisce,

Spiritus lauri cinnamomi ^iss.

Acidi sulphuric! dHuti

■3iimantur infusionis cochlearia tria, quarta quaque Korii.

.• PREPARATIONS OF IRON.

367

Preparations of ii’on, like chalybeate waters, are un-
questionably stimulants of a very universal effect on
the animal system. They restore the strength, enliven
the vascular actions, improve the complexion, cure hy-
pochondriasis, hysteria, disordered stomach, and uterine
obstructions : and they as invariably augment disorders
of the brain, endangering palsy, and often hastening on
a paralytic stroke. One of the most simple forms ip
which iron is administered, is the powdered rust of iron,

521. Be. Carbonatis ferri 9iv.

' Magnesias.

Sacchari.

Pulveris aromatic! aa ^ii.

Misce, et divide in partes sequales duodecim, quarum
sumat aeger unam ter in die.

522. Br. Tincturas feni muriatis Ji.

Sumantur guttae quindecim, ter in die, in quovis vehi-
culo idoneo,

523. Be. Tincturse ferri acetati ^i.

Capiat guttas triginta, ter in die.

524. Be. Carbonatis fem.

Pulveris zingiber, aa gr. vi.

Confectionis rosae q. s.

Ut fiat bolus, ter in die sumendus.

I

525. Be. Pulveris colombae 5ss.

Sulphatis potassae ^i.

Fiat pulvis, bis in die sumendus.

i..

S68 OF CINCHONA, AND PREPARATIONS OF IRON.

526. Sc. Supertartritis potass®,

Magnesi® aa ^ss.

Confectionis aurantii ^i.

Pulveris cinnamomi 511.

Carbon atis ferri ^i.

IMisce, ut fiat electuarium; sit cochleare parvum pro dosi,

527. R. Pulveris cinchon® officinalis ^i-

Carbonatis ferri 3h
Confectionis aurantii
Syrupi zingiber, q. s.

Ut fiat electuarium ; sumatur cochleare parvum, ter in
die.

528. Be. Sulpliatis ferri 9i.

Extracti gentian® lute® 5i“

Pulveris aromatici 3ss.

Fiat massa, dividenda in pilulas No. 18. : siimat *®ger
duas, ter in die, superbibendo haustum infusionis ali-,-
cujus amar®.

529. Br. Sulphatis ferri gr. iv.

Extracti cinchon® gr. xxxii.

Syrupi q. s.

Ut fiant pilul® No. 16. ; sumatur una quater in die.

I

530. Be. Extracti cinchon®.

Pulveris myrrh® aa 5iss.

Sulphatis ferri ^iss. ' ,

Olei cinnamomi gtt. v.

Syrupi zingiber, q. s.

Ut fiant pilul® No. 40. : sumantur quatuor ter in die.

\

531. Be. Ferri ammoniati gr, v.

Rad. rhei palmati gr. iii.‘

Fiat pulvis, in quolibet vehiculo idoneo quotidie ?u-
mendus.^

IRON, CINCHONA, COLOMBA, &:C.

532. R. Tinctiirae muriatis ferri gtt. xv.

Aquffi cinnamomi ^ss.

Syrupi rosae 5^^-

Fiat haustiis, ter in die sumendiis, in aqua? cyatho.

533. R. Gummi resinas myrrlice,

Pulveris colombfE aa
Carbonatis ferri 5i-

Divide in partes duodecim : Sumatur pulvis bis qiiotl-
die, in pauxillo syrupi.

534. R. Subcarbonatis sodse gr. iv.

Pulveris colombse gr. vi.

Fiat pulvis, bis in die in synipo vel melle exliibendus.

Yet I am careful not to load the stomach of a child,
nor to provoke puking with many or frequent bitter
draughts.

535. R. Tartratis ferri.

Magnesiee aa gr. x.

Sacchari gr. xxv.

Olei menthas piperita? gr. ii.

' Fiat pulvis, ter quaterve in die sumendus.

536. R. Ammoniatis ferri.

Pulveris zin^ber. aa gT. xii.

INIucilaginis q. s.

Ut fiat bolus, bis die sumendus.

I

537. R. Pulveris cinchona? officinalis 5!.

Sulphatis potassae cum sulphiire 3vi.

Tere simul, et divide in partes duodecim ; sumatur
pulvis mane et vespere, vel ter in die.
vpL. III. A a

470 PREPARATIONS OF IRON, COLOMBA, 6cC,

538. R. Ferri ammoniacalis or. iv.

Pulveris cinchonae officinalis 9i.

Fiat pulvis, ter in die sumendus in syrupo.

539. R, Pulveris aloes compositi 5i-

Sulphatis ferri 9i. '

Pulveris rhei palmati 3SS.

Balsami pemviani q. s.

Ut fiat massa, dividenda in pilulas No. 36.: sumat
feger duas nocte maneque.

540. R. Pulveris myrrhas ^ss.

Sulphatis ferri gr. iii.

IMucilag. g. m. niloticas.

Syrupi aurantii aa ^ii.

Aquas menth. piperit. 51.

Fiat haustus, ter in die sumendus.

541. R. Pulveris myrrhae gr. xv. ’

- — r- rhei palmati gr. iii.

raromatici 0i. ’

3Iisce, ut fiat pulvis, ter in die sumendus.

542. R. Radicis colombas.

gentianaf.

Calami aromatici.

Corticis aurantii aa 5ii-
Vini Hispanic!, (Madeira) libras duas.
Infundantur per dies octo: hujus infusionis sumantur
cochlearia tria bis in die.

543. R. Radicis gentianas 1 ute® 3SS.

’ Seminum coriandri.

Corticis aurantii exsiccatse aa 3i-
Alcoholis diluti 3iv.

PREPAEATIONS of iron, COLOjVIBA, &C-

371

Infunde per tres horas, dein adde aquae ferventis libram.
Infusio stomachica, cujiis sumatur cyathum parvum,
ter in die.

This is an excellent stomachic ; it is the bitter in-
fusion of the Edinburgh Dispensatory; and the half,
or indeed the whole almost, might be taken in the day.

544. R. Myrrhae 5ii-

Sulphatis ferri 5ss.

Subcarbonatis potassae 5ss.

Mucilaginis g. m. niloticae.

Syrupi zingiber, aa 5U. ; Misce terendo,
myrrhum, sulphatem ferri, et subcarbo-
natem potassae, mucila^ni et syrupo :
dein adde.

Aquae menthae piperitae.

fontis aa ^viii.

Tincturae aurantii

Sumantur cochlearia tria magna, ter vel quater in die.

545. R. Tincturae colombae

Aquae menthae piperitae 3xii.

Fiat haustus, ter in die sumendus.

546. R. Pulveris radicis colombae 9ss.

Carbonatis ferri gr. vi.

Fiat pulvis, mane et vespere sumendus, in cyatho aquae
menthae piperitae.

547. R. Pulveris rad. colombae.

zingiber, aa 3ii-

Supertartratis potassae

Misce, et divide in partes aequales duodecim : sumantur
pulveres ter in die.

A a 2

S72 OF STOMACHIC BITTERS AND SULRHATE of<- ZINC.

548. R. Piilveris cuspariae vel corticis Angiistiirae

5ii-

Carbonatis calcis 9ii.

Divide in partes tequales duodecira, una ter in die SU’.
menda.

549. R. Pulveris subtiliss. ciispariae gr. xv.

' Pidveris rhei palmati gr. v.

magnesiaB gr. x.

Fiat pulvis, ter vel quater in die sumendus.

550. R. Oxydi zinci 9ii.

Pulveris lauri cinnamomi compositi,
Sacchari puri aa 5i-

Misce in pulverem, dividendum in partes duodecini
sequales, quarum siimatur nna mane^et nocte quo-
tidie.

The sulphate of zinc, except as an emetic, is rarely
used, though some are inclined to ascribe to it tonic
powers. Less than a quarter of a grain is usually given
at a dose, but it is repeated to the extent of three ot
four grains in the day, sometimes dissolved thus :

551. R. Sulphatis zinci gr. iv.

Aqute rosfE gallicje 5vi.

Tinctur® aromatica? ^i.

Sumantur coclilcaria tria magna, tertia vel quarta qua-
que hora.

552. R, Sulphatis zinci gr. iv.

Extract! glycyrrhizi glabri 5i-
Fiat massa dividenda in pilulas duodccim ; quarum ca-
piat aeger duas ter quaterve die.

A5IM0NIARET OF COPPER AND ARSENIC. 373

. ‘J'hough we were to ransack the records of all ages,
\Ve should probably find few other reputed tonics be-
sides those now enumerated, and none efficacious. Two
only remain to be described, and those of ambigaioiis
character as tonics, and proverbially dangerous, viz. cop-
per and arsenic ! on which the caprice or fashion of the
hour has set a high value.

-J *

553. Be. Ammoniareti cupri gT. viii.

ISIicae panis 9ii.

Aqua? subcarbonatis ammoniae q. s.

Ut fiat massa, dividenda in pilulas No. 16. : siimat a'gep
tres -vel quatuor in die.

554. R. Oxidi arsenici.

Subcarbonatis potassas utriusque grana duo<

AquEB distiUataG uncias qiiatiiordecim *,
priora duo, in aqua in vitrea lagena co-
quite, donee soluta fuerint ; frigefactaiu
liquorem, per chartam cola, dein adde,

Tincturae lavendula^ compositae uiK'ias duas.
Sumatur semimcia bis in die, gradatim dosin augcns ad
unciam.

r

This is a medicine difficult and dangerous to use! It
is recommended in fevers, especially of the intermittent
kind ; in epilepsy, in angina pectoris, and in periodic
headaches. It is perhaps fnore useful in bad impetigi-
nous ulcers, than in any of those diseases ; and in can-
cer also, especially when used externally as a caustic, in
the manner by and by to be explained.

It will be observed, that the dose above described^
(viz. half an ounce of the arsenical liquor), conveys the
sixteenth part of a grain twice-a-day, increasing gra-
dually to tlie eighth of a grain : and let it be observed.

374

OF ASTRISTGENTS.

that the doses, whether repeated twice or three times l-
day, should be given at very regular intervals : in all
diseases the prescription, and the manner of giving the
medicine, is the same. If sickness or griping ensue, the
medicine should be discontinued ; if they increase, some
warm cathartic should be given, followed by opiates and
broths ; arsenic, even when it produces no such alarming
symptoms, must not be long nor uninterruptedly used.
It is the basis of nostrums for the cure of poisonous bites,
as of serpents, and of the mad dog : and the impartial
experiments of scientific men, using those ague-drops,
and cures for hydrophobia, have flattered us with the
hopes of the medicine being sometimes successful.

Of Astringents.

It is not possible to speak of the use of lead internally,
without a vehement protest against so wanton an expe-
riment upon the health of any human creature.

555. R. Superacetat. plumbi gr. ss.

Confectionis ros£e gr. iv.

Tincturag opii gtt. ii.

Fiat pilula, quarta quaque hora sumenda, in haemop-
tysi.

556. R. Folior. rosae gallicae 5ii»

Aquas ferventis 5''^ii* *, fiat infusio ; ^fusion!
adde,

Syrupi rosse 5!.

Acidi sulphurici diluti 5iss.

Tincturas opii gtt. xxx.

Fiat mivStura, ciijus sumat aeger cochlearia duo magna,
quater in die in hEemorrhagia pulmonum, ventriculi,
vel uteri.

QF MINERAL ANp VEGETABLE ASTRINGENTS. 375

557. Be. Laetis vaccini buUientis libram.

Supersulphatis aluminis et potass® 5ii-
Ebullient simul, ut fiat coagulum ; coletur serum> et
sumatur saepe in die.

558. R. Supersulphatis alumin® et potass®.

Extracti cinchon® aa gr. x.

Fiat bolus, ter in die sumendus.

559. R. Supersulphatis alumin® et potass®.

Pulveris subtil, fol. ros. gall, aa

zingiber. 3i*

Opii duri purificati gr. vi; : .

Tere simul optime, ■ et divide in p. ®. duodecim : suma-
tur una quater in die, in cyatho infus® ros® gallic®
in h®matemesi. •.

560. R. Acidi sulphurici aromat. ^i.

Sumantur quater in die guttae triginta in aqua frigida.

561. R. Sulphatis zinci gr. xii. solve in

Aqu® distillat®

Sumatur tertia pars, ter in die, augendo dosin si opus
sit.

562. R. Succi spissati mimosae catechu.

Supersulphatis alumin® et potass® aa gr. x.
Opii duri gr. ss.

^ Conserv® ros® q. i§.

Ut fiat bolus> ter in die sumendus!

• 563. R. Electuarii eatechru

Carbonatis calcis aa 5ii. ‘

Mucilag. g. mimos. nilotic®. . -

Syrupi zingiber.

376 or VEGETABLE AND MINERAL ASTRINGENTS.

Aquae lauri cinnamomi aa 311.

Tincturse opii 5i-

Fiat mistura, cujus sumantur cochlearia tria magna, ter
in die.

564. R. Electuarii extracti catechu 9 , h

Aquae lauri cinnamoini ^i-
Synipi aurantii 3SS.

Tincturae kino 3ss.

— opii gtt. X.

Misce, ut fiat haustus, saepe in die sumendus,.

565. R. Supersulph. alum, et potass.

Extracti corticis cinchonae aa 5i.

Gummi kino 3ss.

Fiat massa, dividenda in pilulas triginta ; sumat a^er
tres vel quatuor ter in die.

566. R. Carbonatis calcis ^ii.

Syrupi zingiber, ^u.

Aquae rosae gall. ^vi.

Tincturee opii ^i.

Spiritus lauri cinnamomi.

■ - colombae aa ^i.

Misce : sumatur cyathus parvus quater in die.

The potio cretacea of the Dispensatories, is a mixture
of the carbonas calcis with sugar, gum mimosa nilotica,
water, and spirituous cinnamon water. This is an ad-
mirable and useful composition, fit to be kept ready,
and made fresh from day to day for hospital use ; but
apt to become acid in the apothecary’s shop ; and better
replaced with extemporaneous prescriptions. To the
potio cretacea, the addition of rhubarb, of small doses

OP VEGETABLE A8TRIKGENT3. 377

of IPECACUAN, and of laltdanum, adapt it to the va-
rious degrees and characters of ^vine fluxes.

The PULVis carbonatis calcis, represents this chalk
mixture, and mixed with mucilage and water, forms it.
The pulvis carbonatis calcis consists of chalk, nutmeg,
AND CINNAMON. The PULVIS CARBONATIS CALCIS CUm
opio, is the same, mixed with opium in such proportion
as to convey a grain of opium in two scruples of the
powder.

The electuarium catechu, is a third well-imagined com-
pound, the CATECHU being combined with kino, opium,
cinnamon, and nutmeg- The proportion of opium in
it is too small, being no more than a grain and a quar-
ter to half an ounce of electuary, or confection as it has
been termed, of catechu. The pulvis kino compositum,
is a fourth combination, also very useful, conveying a
grain of opium in one scruple of the powder; it may,
like the others, be mixed in draughts,.. w given in pow-
der, to the quantity of ten grains three or four times
a-day.

567. R. Pulveris kino composit.

colombae.

aromaticfe aa gr. x.

Sumatur ter in die, in dysenteria.

568. R. Pulveris serpentariae.

carbonatis calcis cum opio aa gr. x.

Aquaa menth. pip. 5!.

Syrupi aurantii 5iii-
Fiat haustus, ter in die sumendus.

569. R. MisturjB cretaceaa ^i.

. Confectionis aromaticfp.

Electuarii catechu aa 9^ii.

Pulveris ipecacuanhsB gr. ii.

Fiat haustus, quarta quaque hora sumendus;

OF VEGETABLE ASTRINGENTS-

S7S

570. R. Pulveris rhei pahnati.

Carbonatis calcis aa 5ii-
Pulveris ipecacuanhae cum opio 9ii.
Pulveris zingiber. 9i. m.

Ut fiat pulvis, dividendus in partes duodecim : sumatuf
una ter in die, in quovis viscido vehiculo.

571. R. Pulveris rhei palmati 5ss.

Confectionis aromaticas 9i.

Tincturae rhei 5ii.

Pulveris ipecacuanhae gr. iii.

' Aquae menthae piperitae 5iss.

Syrupi3ii.

Tincturae opii gtt. xxv.

Fiat haustus.

572. R. Cortids quercus roboris pulverizati vel cob-

tusi.

Corticis cinchonae officinalis aa ^i.
Confectionis aurantii ^ss.

Aquae ferventis libras duas; macera leni
calore per horas duas, dein cola, et cola*
turae adde,

Spiritus cinnamomi 5iii.

Acidi nitrici 3iii-

Sumantur cochlearia tria magna, secunda quaque hora ;
in diarrhoea, dysenteria, febri remittente et intermit*
tente.

573. R. Corticis quercus roboris drachmas duas.

Aquae ferventis libram; coque ad uncias
octo, et adde,

Supersulphatis aluminis et potassae drach-
mam.

Syrupi semiunciam.

OF VEGETABLE ASTRINGENTS.

* m

Sumantur cochlearia tria magna ter in die, rarius vel sae-
pius ; in diarrhoea, dysenteria chronica, sed maximum
cum abilitate in sanguinis profluvio.

574. R. Haematoxyli campechiani ligni rasi sescun-

ciam. •

Corticis lauri cinnamomi.

lauri cassias aa 5ii-

Pulveris bacc« capsicas indici '

Sacchari puriss. ^ss.

Aquae ferventis libras duas ; decoque lignum
hasmatoxyli, cort. casske et cinnamomi, in aquae
bilibras ad unam ; adde sub finem coctionis, sac-
charum et capsicum ; dein,

j Vini rubri ^iih ' ' "

Sumatur uncia ad 'duas tertia quaque hora. ‘ ' * '

575. R. Confectionis aromaticae. ’ i i .1

Extract! hsematoxyli campechiani' aa 9i.
Mistur® cretace® ^iss. »

Eiat haustus, quater in die sumendus.

576. R. Fob arbutus uv® ursi 3i»

Olei terebinthin® q. s.

Ut fiat massa, dividenda in pilulas duodecim ; sumantur
tres ter in die.

577. R. Fob arbutus uv® ursi 3ss.

Magnesi® ^i.

Fiat pulvis ter in die sumendus, superbibendo haustus
aqu® acidi carbonici. *

578. R. Pulv. fob arbuti uv® ursi 3iii

Subcarbonatis sod®.

Pulveris aromatic® aa 3ib

580 Of external stimulants and astringents.

Misce in pulverem, dividendum in p. ae. duodecim : su-
matur una ter vel qiiater in die, in nepliriti, morbo
vesica? miicoso, .vel catarrhali, &c.

• * . r

OF EXTERNAL STIMULANTS AND' ASTRINGENTS.

Stimulant applications are to be distinguished from
astringent, both by their purpose and their form : The

STIMULANT applications being used for exciting and
maintaining vascular action, and nervous sensibility ;
ASTRINGENT apphcations, to abate sensibility, and re-
strain vascular action. Stimulants are chiefly applied
in form of hot fomentations,' spirituous embrocations,
and warm oils, and plasters. Astringents are applied
chiefly in form of watery solutions, and almost always
cold. Stimulants are sometimes used for the relief of
deep-seated inflammatory diseases, as in the viscera,
joints, and bursae ; but never in superficial or cutaneous
disorders of that nature ; while astringents are used
in all external inflammations and ulcerations, and alsa
in those of hollow tubes, viz. in inflammations and shght
exulcerations of the skin, scalp, eyes, lips, throat, ure-
thra, uterus, vagina, &c.

OF stimulant FOMENTATIONS, EMBROCATIONS, OIL^
OINTMENTS, POWDERS, AND CATAPLASMS.

Fomentations.

579. R. Alcoholis diluti Ibss.

Acidi acetici diluti Ibi.

Muriatis ammoniae 5iii-

Pro fomento, in contusione, vel contortione articulonim,
tepide vel frigide linteis madefactis imponendum.

STIMULANT FOMENTATIONS & EMBROCATIONS. 381

580. R. Aquae acetatis ammoniae Ibi.

Alcoholis Ibss.

Misce pro fomento, frigide vel tepide admovendo,

581. R. Aceti Ibi.

Alcoholis diliiti Ibss.

Acidi sulpliurici dilut.

Mellis despumati aa 5ii.

INIisce pro fomento, in iilceribus sordidis.

582. R. Artemisii abrotani.

maritimi.

Menthae sativae.

Anthemidis nobilis aa manipulum.

Aquae fontis libras tres j decoque ad duas,
adde,

' Alcoholis diluti 3iv.

Ammoniae mur. ^hi.

Fiat fomentatio, ter in die tepide imponenda.

Stimulant Embrocations.

The Solutio Saponis, which enters into many of the
stimulant embrocations, is formed by dissolving an ounce
of soap in a pound of dilute alcohol.

583. R. Solutionis saponis uncias duas.

Aquae acetatis ammoniae uncias quatuor.
Addatur interdum.

Aquae ammoniae

L

JS2 STIMULANT EMBROCATIONS AND LINIMENTS^.

584. Be. Saponis albi duri

Camphorae ^ss.

Alcoholis diluti.

Aquae fontis aa Ibss.

Fiat embrocatio.

This is the Compound Soap Liniment, to which is
often added laudanum, in the proportion of one ounce
of laudanum to three of the saponaceous liniment.

585. Be. Olei oleae Europeae ^ii.

Aquae ammonia Ji. ; misce.

In rheumatalgia, cynanche parotidea, tonsillari, et in
morbis articulorum idoneum.

586. Be. Olei oleae Europeae 3ii.

Camphorae 3SS. ; misce.

587. Be. Camphorae ^ii- solve in

Alcoholis 5iv.

588. Be. Olei oleae Europeae 3U.

— terebinthinae.

Aquae fontis.

Ammoniae liquidae aa 3SS.

Fiat linimentum, egregie stimulans.

589. Be. Mellis despumati.

Terebinthinae venet. aa 3i.

Farinae q. s.

Ut fiat cerateum pernionibus, et ulceribus phagedenicis, '
&c. applicandum.

590. Be. Tartratis antimonii.

Camphorae aa 9i.

Adipis suillae Ji. ; m.

OF STIMULANT LINIMENTS.

383

591. Be. Tartratis antimonii 5i-

Linimenti saponis terebinthinatae 5U. Misce.

592. Be. Solutionis saponis.

Olei oleae Europese aa Ji*

Tincturae lyttae.

Olei distillati pini laricis aa ^ss.

Misce pro linimento, in arthrodynia, paralysi, spasme
idoneo.

593. Be. Olei oleae Europese Jiii,

— pini laricis Ji.

Acidi siilphurici gtt. xx. m.

594. Be. Linimenti camphorati Ji.

Tincturae lyttae.

opii aa ^ss.

Aquae ammoniae Misce,

595. Be. Opii 5ii*

Camphorae 9i.

Alcoholis q. s. ad solvendum camphorum.
Adipis suillse Jss.

Fiat linimentum.

596. Be. Vitelli unius ovis.

Olei terebinthinae 3i.

Tincturae opii ^ss.

Misce ut fiat linimentum.

597. Be. Camphorae.

Aquae kali praeparatae singulorum ^i. solve
et adde,

• Olei oleae Europeae ^iii.

384 STIMULANT LINUMENTS AND EMBROCATIONS.

598. R. Campliorse (ope alcoholis in pulverem ‘tc*.
dacti) 5ss.

Adipis suillse pr^eparatae 51.

Ammoniae liquidae

IMisce, linimentum excitans, idoneum in paralysi, apliro^*
• dysia, in distentione paralytica vesicae urinariae, &c.

599- R. Ammoniae liquidae ^i.

Spiritus oetheris sulphiiriei ^ss.

Tincturae lavendulae ^ii.

Misce pro embrocatione, in hydrarthros, rheumatalgia»
odontalgia, et in morbo faciei dolorosp, hodie nuncu-^
pato “ tic douloureux.”

600. R. Saponis sebacei rasi.

Olei terebinthinae aa ^i-
S'ubcarbonatis potassae solve in
Alcoholis diluti camphorati ^vi.

M. ut fiat embrocatio saponis terebinthinatus, in rheu-
matalgia, paralysi, pernio, contortione articuli, appi-
canda ; cui adde, ut fiat embrocatio rubefaciens.
Ammonias liquidae ^i.

Tincturas lyttas ^ss.

601. R. Unguenti resins flavas 5m.

Camphoras pauxillo alcoholis solutae in pul-
verem redactae ^ss.

Olei terebinthinae q. s.

Ut fiat epithema, in rheumatalgia, artliritide paralysi ap-
plicandum.

602. R. Pulveris sinapis albi 5ii-

Olei olivse 3vi.

terebinthinae 5viii>

jMisce pro linimento.-

STIMULANT CATAPLASMS.

385

603. R. Semiiium sinapis albi.

Medullge panis aa Ibss.

Aceti q. s.

Ut fiat cataplasma, excitans, rubefaciens, in inflamma-
tionibus articulorum applicandum.

604. R. Seminum sinapis nigri contusorum.

Farinas.

Medullae panis, utriusque unciam.

Aceti q. s.

Ut fiat cataplasma, vi vitse deficiente in febribus in stu-
pore, comate febrili, apoplexia, plantis pedis, malleolis
vel cruribus, vel scrobiculo cordis, imponendum.

605. R. Allii sativse quantum vis.

Contusa radice, et in pauxillo alcoholis macerata, appli-
catur plantis pedis, in ultimo febris typhoidis stadio,
in apoplexia, lethargo, hydrope, &c.

Certain external remedies are useful, not in rousing
the vital powers, nor remedying nervous pains, or rheu-
matic diseases, but in resolving indolent swellings, or
exciting such a degree of vascular action as to cause
SUPPURATION. Those are chiefly stimulant plasters and
ointments.

606. R. Muriatis sodas ^i.

Pulveris lini usitatissimi.

Farinae avenaceae aa Ibss.

Aquae fontis q. s.

Ut fiat cataplasma : Stimulans, resolvens, tumoribus
chronicis aegre, glandularum conglobatarum cervicis,
glandulae thyroidese applicandum.

VOL. III. B b '

386

STIMULANT PLASTERS.

607. R. Emplastri oxydi plumbi semivitrei partes

duodecim.

Gummi resinae ammoniaci.

• ■ — — galbani.

Balsami pini laricis.

Cerae flavag ; singulorum partem unam lique-
facto, probe movendo commisce. '

608. R. Farinaj.

*

Saponis terebinthinatae.

AUii cepae tosti aa partes aequales.

JMisce, ut fiat cataplasma, pus maturans.

609. R. Allii cepae quantum vis.

Coque in aqua ad aptam mollitiem.

610. R. Gummi resinae ammoniaci quantum vis;

redige in pulverem, et adde,

Aceti scillitici q. s.

Ut fiat emplastrum.

611. R. Muriatis ammoniac Jss.

Saponis ^ss.

Emplastri lithargyri ^ii.

Eiquefacta sapone’ et terebinthina, miscetur ammonia, ct
imponatur sine mora emplastrum.

These, or the ointment of tartrite of antimony, have
often very powerful influence- in dispelling strumous
swelhngs of the glandulae concatenatae, in discussing in-
cipient white-swellings of the knee joint, and in bring-
ing to maturity scruphulous buboes, and other indolent
tumours.

STIMULANT PLASTERS,

387

612. R. Emplastri picis

Opii.

Camphorae aa
Pulveris lyttas 9i. m.

613. R. Muriatis sodas ^ss. solve in ■ • *

' Aquas tepidse
Fellis tauri recentis.

Olei oleae Europeae aa
Opii.

Camphorae aa 3ii.

Misce, ut fiat linimentum, quo struma assidue perfricam
da est ; et post frictionem, admovendum est emplas-
trum calidum, stimulans.

614. R. Emplastri oxydi plumbi ^ss.

. Muriatis hydrargyri 9i.

Tartratis antimonii Qi.

Misce secundum aitem, ut fiat emplastrum.

But when inflammation has terminated in gangrene,
the living parts are to be stimulated, and the dead parts
separated, and the sloughs and putrid serum (the ob-
sorption of which poisons the system) to be corrected,
by applying camphorated and stimulating medicines, in
the form either of poultice or powder.

615. R. Vini rubri Ibii.

Farinse avenaceas q. s*

Ut fiat cataplasma, cui adde

Olei distillati pinaS laricis ^ss.

Olei camphorati ^i.

B b 2

388 STIMULANT CATAPLASMS, WASHES & INJECTIONS.

616. R. Camphorse 5SS. solve in

Olei pini laricis
Cataplasmatis domestici.

Piilveris carbonis ligni aa
Alcoholis diluti q. s.

Ut fiat cataplasma, antisepticum stimulans. ^

617. R. Nitratis potassae. ^

Gummi resin® myrrh® aa ^ii.

Camphor® pauxillo alcoholis in pulverem
reduct® ^ss.

Misceantur, ut fiat pulvis antisepticus, stimulans, quo
inspergantur partes, gangrenos®, putrid®, superim-
ponens lintea alcohole camphorato imbuta.

There are various disorders, surgical as well as medi-
cal, wliich require the strong excitement of stimulant
washes and injections, usually composed of tinctures of
bark, myrrh, laudanum, or muriate of mercury or am-
monia. The less important occasions, as that of relaxed,
spongy, and ulcerated gums, tonsils, &c. require only
more dilute injections or washes of the same medicines
which suit the more desperate diseases, as disorders of the
antrum Highmorianum, syphilitic diseases of the spongy
bones, and palate, or superficial ulcers of sloughy or gan-
grenous tendency.

618. R. Decocti cinchon® officinalis ^iv.

Tincturee myiTh® Ji.

Fiat lotio vel injectio.

619. R. Tinctur® myiTh®.

cinchon® officinalis aa ^ii.

Aqu® ros® 5iv. m.

I'iat lotio.

STIMULANT WASHES AND INJECTIONS- 389

620. R. Tinctuiae aloes.

myrrhae aa ^ii.

Aquae calcis Ibi. m.

621. R. Muriatis hydrargyri gr. x.

ammoniae 9ii. solve in

Alcoholis ^i.

Tincturas opii
Aquae rosae Ibi. misce.

622. R. Decocti corticis cinchonae ^xii.

Tincturae myrrhae Ji.

Muriatis hydrargyri gr. x.

Mel. rosae 5!. misce.

623. R. Opii 5ii- solve in

Aquae feiwentis ^vi. m.

For exciting the secretion of the cerumen, the defect
of which, and the corresponding state of the membrane
of the ear, is a frequent cause of deafness, we 6ften use
stimulant oils and ointments, all of which must be in-
troduced into the tube of the ear with much caution ;
sometimes we use opium, sometimes camphor, some-'
times aloes, and sometimes the gall of animals.

624. R. Fellis bovinae 5ii*

Olei oleae Europeae 5SS. misce.

625. R. Felhs bovinae.

Opii aa ^ih

Adipis suillae ^ss. misce.

626. R. Camphorae.

Opii aa 5i*

Unguenti hellebori nigri ^ss. misce.

390 OINTMENTS, &C. FOR CUTANEOUS DISEASES.

627. R. Olei oleae Eiiropeas gss.

pini laricis gtt. x.

For Tinea Capitis, and other foul cutaneous ulcers,
we use the pitch plaster, and mercurial ointments, al-
ternated with the stimulant washes just mentioned,
washes and fomentations of hot salt water.

628. R. Resinse pini liquidae Ibss.

Cerag flavae ^ss.

. Sulphuris ^ii.

Misce, ut fiat unguentum.

629. R. Muriatis sodae ^ss.

hydrargyri gr. x. solve in

Aquae ferventis Ibi. ; adde,

AlcohcJlis diluti 5ii.

Misce, fiat fomentatio, mane et vespere calide appli-
canda.

630. R. Unguenti hellebori albi

Oxydi hydrargyri rubri 5i-

]\Iisce, ut fiat unguentum, raso capiti illinenda, locis
scabie faedatis, hora somni ; mane diligenter lavatur
capillitium, solutione saponis in aqua tepida.

631. R. Cj^rbonat. calcis.

Oxydi plumbi albi aa ^i.

iMisce, ut fiat pulvis, quo inspergatur capiUitium, erosa
scabie.

For psora, the sulphur ointment, ointment of extract
of hyoscyamus, of rue, or of hellebore, are used ; the
latter especially is effectual, and is the basis of the best
quack ointments for the itch.

ASTRINGENT SOLUTIONS.

391

632. R. Pulveris hellebori albi 5!.

Adipis suillffi Jviii.

Olei citri medici gr. xx.

Misce pro unguento anti-psoradico.

This is the safe, speedy, and effectual cure.

When we would make assurance doubly sure, we add
a proportion of the red oxide of mercury ; and though
it might seem dangerous to anoint the whole surface
with such a composition, we by experience know it
to be safe ; it should be washed off every night with
warm water and soap.

OF astringent solutions for washes, collyria,

AND INJECTIONS.

The class of astringents is already sufficiently defined
and described, and no great art can be required to ar-
range the prescriptions usefully, nor should any be af-
fected. Astringent applications should be simply and
plainly arranged according to their use and intention.

1^^, As washes, solutions, or powders, for excoriations,
ulcerations, or sores.

2fZ, As collyria, or astringent and gently stimulant
solutions, and ointments, for the eyes and eye-lids.

3c?, As gargles, or stimulant and astringent washes,
for ulcers of the tonsils and throat.

As injections and washes for moderating uterine
discharges, for suppressing mucous fluxes from the va-
gina, and for assuaging the pains of cancer of the womb.

One of the most valuable astringents I am acquainted
with, though the least used, is wine. Vinegar is a most
useful astringent, alcohol another excellent ingredient in

1

392 ASTRINGENT WASHES AND INJECTIONS. *

)

astringent infusions ; but rough port wine combines the
entire acid, and alcohol, and should be the menstru-
um or chief fluid vehicle for other astringents. Port
wine diluted, strengthened with vinegar, with acetas
plumbi, &c. makes a valuable injection in gonorrhoea ; i
sour claret, an excellent coUyrium ; and hot wine, one
of the best stimulant stupes, when combined with
aromatics, and used hot ; or one of the most valuable
astringents, when applied cold, and on most occasions
an excellent gargarism.

633. Be. Corticis quercus roboris 5SS.

Aqu£B Ibiss. decoque ad libram, et adde,
Supersulphatis aluminae et potassae 3ii*

Aceti 3iv.

Fiat mistura astringens, pro fomento, injectione, vel gar-,
garismate.

634. Be. Corticis salicis ^i.

quercus roboris ^ss.

Aquae Ibiss. decoque ad libram ; adde,

Acidi sulphm-ici diluti 5iv.

Fiat infusio astringens, quo lavantur ulcera, haemor-
rhoides, ani prolapsus, saepe in die ; injiciatur inter
vaginam, in fluore albo, prolapsu uteri, procidentia
Auginae, &c.

' 635. Be. Pulveris quercus cerris Ji.

Aquae Ibiss.

Decoque ad libram pro fomento ; pannis laneis, admo-
veatur tumoribus haemorrhoidalibus, mane et vespere ;
vel in uteri, vel in vaginae procidentia. I

636. Be. Muriatis hydrargyri ^ii.

Aquae calcis Ibii,

astringent washes and injections. 393

Fiat solutio astringens, stimulans, pro scabie, ulceribus
cutaneis, syphili, &c.

637. Be. Muriatis ammoniae *

Alcoholis diluti
Aceti ^vi. misce.

638. Be. Acidi nitrici diluti 3ii»

. Infusi rosas Ibi.

Fiat lotio, ulceribus foetidis, heemorrhagicis applicanda.

639. Be. Sulphatis zinci 3*- solve in

Aquae distiUatse ^viii. ; dein solve
Acetatis plumbi 5SS. in
Aquae distiUatae 3X.

JMisceantur liquores, quiescant, coletur solutione ace-
tatis zinci.

640. Be. Supersulphatis aluminae et potassae 3ii-

Infusi rosae ^vi.

Aceti puri 5U. m.

Ut fiat solutio astringens, naribus injicienda in epistaxi,
vel recto in profluvio sanguinis periculoso, e vasculis
haemorrhoidalibus interioribus.

t

641. Be. Sulphatis cupri.

Supersulphatis aluminae et potassse aa 3iii-
solve in

• ^ Infusi rosae ^iv.

Fiat solutio astringens styptica.

As an astringent in piles, we use, along with opiates
and laxatives, an astringent ointment of galls.

394 astringent and absorbent powders.

642. R. Pulveris quercus cerris 5ii-

Adipis siiilli |i.

Camphorae.

Opii aa 51.

Fiat unguentum.

Astringent and absorbent powders, are far too little
used in the cure of sores and ulcerations. There are
few ulcers which improve when dressed with ointments ;
but if, after the use of warm stimulant or astringent fo-
mentations, an astringent powder be applied, as suggest-
ed in the rules for the cure of ulceration, often in a few
days a sore is healed, which had continued for months.
Of those powders perhaps hardly any can excel the pul-
vis CERUSS.E COMPOSITUS ; I have usually prescribed it
in this form.

643. R. Oxydi plumbi albi,

Carbonatis zinci.

-AmyU aa ^ii. m. ; vel,

644. R. Carbonatis zinci.

Carbonatis calcis.

Oxydi plumbi aa p. se. misce.

Or for haemorrhagic ulcerated surfaces.

645. R. Supersulphatis alumin® et potass®.

Gumm® mimos® nilot. pulverizat® aa 55$.
Carbonatis calcis ^i. m.

Or in dangerous h®morrhages from the nostrils, mouth,
or other ulcerated surface.

646. R. Supersulphatis alumin® et potass® ^iii.

Kino 5i. misce.

COLLYRIA.

595

A portion of this powder diffused, if not dissolved in
claret or port wine, is a valuable injection into the rec-
tum, in hgemorrhagies from the internal haemorrhoidal
vessels ; or into the womb, in dangerous haemorrhages
from abortion, from polypus uteri, or (as sometimes
happens) from a protracted or violent menstrual action,
altogether unconnected with pregnancy or disease. I
have frequently seen women reduced to the lowest ebb
of weakness from such haemorrhages, and have saved
them alive, after being so drained of blood as never to
recover the natural complexion of the cheek or lips.

COLLYRiA,

647. R. Aceti.

Alcoholis diluti aa 5iss.

Aquae rosae ^vi, misce.

648. R. Superacetatis plumbi gr. xv.

Camphorse pauxillo alcoholis solutae gr. vi.
Aceti 5iii,

Infusi rosae ^viii.

Fiat collyrium.

649. R. Camphorae grana sex.

Sacchari purissimi ^i.

Spiritus oetheris nitrici 3ii- ; tere simiil, et
adde.

Aquae acetatis ammoniae ^vi.

3Iisce, ut fiat collyrium.

650. R. Acetatis ammonise hquidi.

Aquae rosse centifofiae aa ^iii.

Tincture hyoscyami misce.

396*

COLLYRIA.

651. R. Zinci sulphatis.

Cerussas acetatas aa 9ss.
Aquae rosae Jvi. cola.

Fiat collyrium.

652. R. Supersulphatis aluminae et potassas 9i.

653. R. Sulphatis zinci 9i.

Spiritus camphorat. ^ss.
Aquae distillatae ^viii-
Misce pro collyrio.

654. R. Muriatis hydrargyri gr. iii.

Aquae kali Phar. Lond. singulonim 5SS.
Olei oleae Europeae ^ii.

Misce, ut fiat linimentum opthalmicum, in opthalmia
asthenica applicandum, in hora decubitus.

656. R. Extract! opii mollis.

Camphorae aa 9ss.

Tere simul in mortario marmoreo, dein adde.
Aquae fontis ferventis ^vi.

Aquae rosae ^iv. misce.

Aquae rosae ^viii.
Tincturae opii 5i- ni.

Syrupi simplicis ^ii.
Aquae rosae ^iv.
Tincturae opii

Misce pro collyrio.

655. R. Camphorae.

The inflammation having terminated in extravasa*
tion, betwixt the laminae of the cornea lucida, or in
other terms, in specks, or opacity, the cure of these is to

COLLYRIA AND OPTHALMIC OINTMENTS. 397

be attempted by more stimulant solutions and powders,
as of copper, corrosive sublimate, &c.

657. Be. Aquae acetatis ammonias gr. iv.

Muriatis ammoniae ^ii.

Aquae calcis recentis Jviii.

Digere per boras viginti quatuor, et cola ; in lippitudine,
vel opthalmia senili, ulceratione chronica palpebrae,
maculae corneae lucidae, et in ulceribus phagedenicis
remedium.

658. Be. Muriatis hydrargyri gr. iv. solve in
' Aquffi distillatae ^viii.

CoU)nium, pro opthalima tarsi, opacitate corneae, &c.

659. Be. Muriatis ammoniae gr. vi.

hydrarg3nri gr. iii.

Tincturae opii 5ii«

Aquae rosae 5vi.

Fiat coUyrium.

660. Be. Subrnuriatis hydrargyri 9i.

Muriatis hydrargyri fortius gr. iii.

Sacchari puriss. ^ii.

Tere simul, ut fiat pulvis, intra palpebris inflandus ope
arundinis, vel calami scriptorii, hora decubitus.

661. Be. Oxidi hydrargyri rubri 5ss.

Adipis suilli ^ss.

Misce pro unguento opthalmico.

662. Be. Oxidi hydrargyri rubri 5i.

Camphorae pauxillo alcohohs solutae 9ii.
Subacetatis cupri ^i.

Adipis suilli ^i-

398 DETERGENT OINTMENTS AND LOTION^.

Tere simul diligenter in mortario calente, ut fiat unguen-
turn, in opthalniia tarsi, intra palpebras intromitten*
dum, ope pencilli. In ulceribus syphiliticis et scro-
phulosis, in morbis cutaneis, impetigenis, &c, opti-
mum est remedium. In opthalmia chronica palpe-
brarum adhibetur, palpebris noctu dormituris inun-
guendo.

• 663. Be. Acetatis cupri ^i.

MeUis despumati ^i.

Misce diligenter, terendo in mortario vitreo. Pauxillum
hora somni introducendum subter palpebras, adhibe-
tur etiam ulceribus scrophulosis glandiUarum, vel cutis,
narium, palati, &cc.

664. Be. Acetatis cupri cry staUisati 3i-

Aqua0 ammoniee ^i.

IMisce, ut fiat solutio ; ad drachmam hujus solutionis,
adde uncias quinque aquas distillatse, ut fiat lotio as-
tringens, ulceribus ssepe in die applicanda.

665. Be. Adipis suilli

Acidi nitrici 5i-

Misceantur ope caloris, in vase figulino, ut fiat unguen-
turn ; in afFectionibus herpeticis, ulceribus syphihticis,
in psora, et in indurationibus glandularum reme-
dium.

666. Be. Adipis suilli pauxillmn.

Acetatis cupri 0i.

Unguenti resinosi ^i.

Misceantur, ut fiat unguentum opthalmicum^

astringent and stimulant gargles. 399

astringent and stimulant gargles.

667. R- Infusi rosae centifoliae ^vi.

Syrupi 5ii.

. Acidi sulphuric! diluti 5iss.

Fiat gargarisma. ' j

668. R. Infusi rosas fvi.

Tincturas myrrhas.

cinchonae officinalis aa ^i.

Misce pro gargarismate. Vel,

669. R. iJecocLl cmchonse Ibi.

Acidi sulphurici diluti 3il«

Misce pro gargarismate. " r j

670. R. Supersulphatis aluminae et potassaB 51* '

Decocti hordei Ibi.

Mellis ^ss. ' ' .

Acidi sulphurici 3ss.

Misce pro gargarismate.

671. R. Mellis flavi ^i.

Aquae fontis Ibi, '

Aceti ^ii.

Misce pro gargarismate ; interdum addatur alcoholis im-*
puri uncia, in cynanche tonsiUari.

672. R. Sub-boratis sodae'.

Mellis aa ^ss. solve in
Aquae fontis Ibi.

Pro gargarismate.

400 STIMULANT AND DETERGENT GARGLES.

673. R. Muriatis ammonise 5ii«

Oxymellis 3!.

Aquse rosag.

Aquas acetatis ammonias aa 3vi.

Misce, ut fiat gargarisma.

These are all useful in the purely inflammatoiy sore
throat, affecting the tonsils and arches of the fauces, and
are useful also, after the tonsils have suppurated, for
washing out the cavities of the ulcerations. But in that
ulcerated or rather gangrenous sore throat, in which the
gums and cheeks fall into a sloughy condition, described
in the section on suppuration and gangrene of the throat ;
or in deep suppurations of the tonsils, or in venereal
sores, we need to Uvse the most pungent gargarisms of
oxymuriatic acid, of the muriates of mercury, &c. mixed
with honey, and penciled upon the sores, with injunc-
tions to the patient to ^ayoid swallowing what is thus
applied. Of the more stimulant gargles, in diseases of
relaxation, the chief are oak bark, peruvian bark, tinc-
ture of myrrh, capsicum, ammonia, and muriatic acid.

674. Be. Decocti quercus roboris ^vi. '

Supersulphatis aluminse et potassae 5ss.

Fiat gargarisma astringens. • ‘ ^

■ ;r

675. Be. Extract! cinchonae officinalis 5k

Decocti cinchonae officinalis. r "

Villi rubri aa 5vi.

Fiat gargarisma.

676. Be. Capsici annui fructus 5k

.vqufe ferventis 3viii. ; infunde per horas
duas et cola, dein adde,

Oxymellis.

Tincturas myrrha2 aa 3!.

^lisce pro gargarismate.

STIMULANT AND DETERGENT GARGLES. 401

677. Be. Tincturse myrrhae,

Mellis ros« Phar. Lond. aa §i.

Infusi rosae ^vi. misce.

678. R. Infusi lini usitatissimi Ibi.

Aquas ammoniae 3iii. misce.

679- R. Decocti quercus Ibi.

Aceti. >

Tincturae myrrhas aa 5L
Sit pro gargarismate.

680. R. Acidi oxymuriatici ^ss.

Aquae hordei ^viii.

Mellis rosae Phar. Lond. ^i.

Pro gargarismate.

681. R. Acidi muriatici 3i- ad 5ii.

Mellis rosae ^i.

Misceantur, ut fiat pigmentum, quo partes sphacelatae
saepe in die ope penicilli tanguntur.

682. R. Muriatis hydrargyri

ammoniae solve in

Alcoholis diluti ^i.

Piat solutio caustica in usum externum, ulceribus syphi-
liticis, verrucis, &c. ope penicilli applicanda.

683. R. Mellis despumati

Acidi oxymuriatici ^iss.

Fiat pigmentum, cujus applicetur pauxillum, ope peni-
cilli, ulceribus palatae, linguae, oris, in apthis, 'ulceri-
bus gangrenosis gingivarum, tonsillarum, &c.

VOL. III. c c

402

DETERGENT GARGLES AND SOLUTIONS. '

684. R. Sub-boratis sodae ^ii*

Mellis rosse.

Tincturae myrrhaa aa ^ss.

Aquae rosae centifoliae ^vi.

Misce, ut fiat gargarisma.

' I

A mineral solution, now extolled, not merely as an
external application in blotches and ulcerations of the
skin, in scrophulous, impetiginous, herpetic, and other
irregular and non-descript diseases, but also as a power-
ful tonic, and especially as a cure for intermittent fever,
is the ARSENICAL SOLUTION.

685. R. Oxidi arsenici ^i.

Nitratis potassae 9ii.

Aquas fontis pondere uncias septem.

Misce in lagena vitrea, in aqua bulliente suspensa, lagena
interdum agitata donee perfecte solutum fuerit ar-
senicum, dein per chartam cola, et adde Tincturae Aro-
maticae ^i. ad 5iss. ut sit pondus accuratum, decern
unciarum.

Pro usu intemo in febribus intermittentibus, pertussi,
epilepsia, morbis herpeticis, &c. ; sit dosis hujus solu-
tionis guttae viginti, sensim sensimque augendo ad
quadraginta, simulac nausea et vomitus, tormina et
diarrhoea occurrunt juvat interponere opiata et dilu-
entia, medicamen elRcax est in pyrexia, salutem idem
brevissimo tempore revocans.

Linteum carptum (charpie dictum) hacce solutione madi-
dum saspe imponendum est ulceribus syphiliticis, erup-
tionibus herpeticis, &c.

INJECTIONS FOR GONORRHOEA, &C. 40f?

INJECTIONS FOR GONORRHOEA, FLUOR ALBUS, &C.

686. R. Superacetatis plumbi 5ss. solve in

Aqu* rosae centifol. Jviii.

Aceti 5ii-

Misce pro injectione.

687. R. Pulveris cerussae compositse

Opii 9i.

Aquai distillatse ^viii.

rosae ^iv.

Tere simul diligenter opium, et cerussae pulverem, dein
adde paiilatim, aquam distdlatam.

688. R. Sulphatis zinci 5ss.

Mucilaginis gummae mimosae niloticae Jii.
Aquae distillatae 3vi. misce.

689. R. Supersulphatis aluminae et potassae 5ii.

Infusi rosae ^vi.

Mucilaginis g. m. nilot. ^i. m.

Pro injectione.

In gleet or continued mucous discharge, higher as-
tringents are required ; and in fluor albus, the mineral
and vegetable astringents must be combined.

690. R. Herbae theae viridis 5ii-

Aquae ferventis ^vii. fiat infusio, adde
Acidi sulphurici diluti gtt. xx.

Pro injectipne.

c c 2

404 INJECTIONS FOR GONORRHOEA, &C.

691. Be. Opii drachmam.

Mucilaginis gum. mimos. niloticas,

Olei oleee Europeae aa 3SS. misce, dein adde,
Sulphatis cupri gr. x.

Aquas rosse ^vii.

Misce pro injectione.

692. R. Sulphatis zinci 9i.

Camphorge in alcoholis pauxillo soluto 31-
Aquas rosae |vi.

Misce pro injectione.

693. R. Sulphatis zinci 3i- solve in

Infus. rosse 3viii.

Aeidi sulphurici diluti guttas xx. rn.

694. R. Vini rubri Lusitanici.

Aquae rosae aa ^iv.

Acidi sulphurici diluti 3i*

Misce pro injectione.

695. R. Corticis quercus 3iv.

Aquas libram decoque ad Jviii.

Cola et adde,

Supersulphatis aluminas et potassae
Fiat injectio in gonorrhoea chronica, et in leucorrheea.
Vel,

696. R. Supersulphatis aluminas et potassae 3ii*

Sulphatis zinci 3i- solve in
Infusi quercus cerris Jviii. m.

When in the high inflammatory stage of gonorrhoea
virulenta, the priapism is such as prevents sleep, and
aggravates the disease ; it is best appeased by giving
opiates, or camphor and nitre draughts, at going to bed.

anodyne injections.

405

and applying at the same time a large and warm cam-
phorated poultice; anointing the whole length of the
urethra with camphorated oi , and making the patient
sit for an hour over the bidet, filled with warm water,
using during the day camphorated, oily, and anodyne
injections, with mercurial ointment mixed in them.

697. B:. Opii 5i- solve in

Aquae fontis ^iv.

Ut fiat injectio, tepide utenda ; interdum addatur ace-
tatis plumbi scrupulum.

698. R. Opii drachmam,

Camphorae drachmas duas.

Alcoholis q. s. ad solutionem camphorae;.
Olei oleae Europeae.

Mucilaginis g. m. niloticse aa ^i.

Aquae distillatae ^vi.

Misce pro injectione anodyna. '

699. B. Aquae acetatis ammoniae 5vi.

Opii.

Camphorae aa ^ii*

Misce pro injectione, quater in die tepide injicienda,

700. B. Unguenti hydrargyri fortius 5ii.

Opii 5i.

Olei amygdali communis.

Mucilaginis g. m. nil. aa ^i.

Aquae ^iv.

Misce, ut fiat injectio, saepe in die utenda.

406

CONCLUSION.

If I have omitted any thing of the immense farrago
of medical prescriptions, it is, 1 hope, what can well be
spared, and what a judicious reader would wish me to
omit. Perhaps the class of Alteratives ! why, all medi-
cines are alteratives, if changing the condition of the sys-
tem be what is meant. But it is changing the condition
of the system sloAvly and imperceptibly that is meant ;
and the medicines peculiarly designated as alteratives,
are no other than the antimonials, mercurials,
NARCOTICS, and sudorific decoctions, which I have
in various forms taught my reader to prescribe ; their
narcotic, diaphoretic, and other qualities, operate slowly,
and the courses are long continued, and hence are named
alterative courses, because they produce no visible alte-
ration !

Demulcents are another class of medicines which
I may be censured for omitting. Demulcent medicines,
those which sheath other more acrid medicines, as lime-
\Vater or alkaline solutions, and medicines which lubricate
thetracliea in cough, or the bowels in dysentery, are indeed
valuable; but I may safely appeal from the custom of wri-
ters on materia medica, to the good sense of my reader,
whether these same demulcents do not pertain more to
the confectioner than to the apothecary ? whether honey,
and figs, and barley- w'ater, tapioca, and sago, and sper-
maceti, almonds, and calf’s-foot jelly, milk, and marsh-
mallows, and lintseed tea, and beef tea, oat meal gruel,
ismglass, and starch, and even gum-arabic, are not ar-
ticles fitter to adorn the scientific pages of Mrs Glass’s
works ? Sure I am, that it were a burlesque upon our
profession, to crow^d a ^vork of this serious nature, with
things so irrelevant, ^vhich need to be remembered be-

CONCLUSION. 407

cause they are often useful, but which need only to be
remembered, not to be described in detail.

One great and general impression I wish to leave on
the mind of my reader, and it is this, that our influence
over the living system is resolvable into three chief
operations.

1st, In allaying inordinate actions, and subduing the
nervous sensibilities of the system, by sedatives and

NARCOTICS.

Q,d, In raising, inciting, and supporting the actions,
and rousing the feelings of the system, by stimulants, to-
nics, and astringents, external as well as internal.

3d, In altering the state of the secretions, by the skin,
kidneys, and bowels, and from all the great surfaces of
the body ; which enables us at once to cure the disor-
ders of these individual organs, and to affect the whole
animal frame.

FINIS.

J. Pil/ans Ejf Sons, Printers, Edinbnrjh.

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